Individual
CANDACE L BLOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
5000 FLOYD RD SW, MABLETON, GA 30126-1608
(318) 425-6280
Mailing address
1850 N MARKET ST, SHREVEPORT, LA 71107-5212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020336
LA
Other
Enumeration date
10/01/2013
Last updated
12/24/2022
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