Provider Demographics
NPI:1700548575
Name:BLOOM PEDIATRIC AND ADULT HEALTH SERVICES
Entity Type:Organization
Organization Name:BLOOM PEDIATRIC AND ADULT HEALTH SERVICES
Other - Org Name:BLOOM MEDICAL TRANSIT
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RASHEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEST
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:215-917-3737
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-0201
Mailing Address - Country:US
Mailing Address - Phone:484-948-5012
Mailing Address - Fax:
Practice Address - Street 1:2575 PERKIOMEN AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PENN
Practice Address - State:PA
Practice Address - Zip Code:19606-2051
Practice Address - Country:US
Practice Address - Phone:484-948-5012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1040569560001Medicaid