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Organization
BLAQOUT, INC.
Active
Organization
BLAQOUT, INC.
Active
Other names
BlaqOut, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
D. RASHAAN GILMORE (FOUNDER/CEO)
(816) 866-0355
Entity
Organization
Contact information
Practice address
517 CAMPBELL ST, KANSAS CITY, MO 64106-1213
(816) 866-0355
Mailing address
517 CAMPBELL ST, KANSAS CITY, MO 64106-1213
(816) 866-0355
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
261Q00000X
Clinic/Center
—
NULL
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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