| Bloom Medical Services | |
|
1315 Burro Ave Cloudcroft NM 88317-7719 | |
| (575) 682-2002 | |
| Not Available |
| Full Name | Bloom Medical Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1315 Burro Ave, Cloudcroft, New Mexico |
| Authorized Official Name and Position | Susan Bruce (OWNER) |
| Authorized Official Contact | 5759212318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Medical Services Po Box 1902 Cloudcroft NM 88317-1902 Ph: () - | Bloom Medical Services 1315 Burro Ave Cloudcroft NM 88317-7719 Ph: (575) 682-2002 |
| NPI Number | 1760956031 |
|---|---|
| Provider Enumeration Date | 01/18/2019 |
| Last Update Date | 07/01/2022 |
| Medicare PECOS PAC ID | 1456767466 |
|---|---|
| Medicare Enrollment ID | O20210316002261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760956031 | NPI | - | NPPES |
| 1326276395 | Other | NM | TYPE 1 NPI |
| 99120330 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LP0200X | Nurse Practitioner - Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Naomi L West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851528723 PECOS PAC ID: 7911052006 Enrollment ID: I20090825000492 |
| Provider Name | Susan Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326276395 PECOS PAC ID: 7416124292 Enrollment ID: I20150724010203 |
Sacramento Mountain Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 74 James Canyon Hwy, Cloudcroft, NM 88317 Phone: 505-682-2542 Fax: 505-682-3075 |