Provider Demographics
NPI:1649833088
Name:BLOOMS BIRTH CENTER
Entity type:Organization
Organization Name:BLOOMS BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NURSING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KINSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:816-809-7996
Mailing Address - Street 1:5523 N FARMER BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-5315
Mailing Address - Country:US
Mailing Address - Phone:417-485-5700
Mailing Address - Fax:417-485-6001
Practice Address - Street 1:5523 N FARMER BRANCH RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-5315
Practice Address - Country:US
Practice Address - Phone:417-485-5700
Practice Address - Fax:417-485-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty