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Organization

BLOOMINGTON MEADOWS GP

Active
Other names
Bloomington Meadows Physicians
Organization subpart
No

Provider details

NPI number
Authorized official
STEVE FILTON (SR VP CFO)
(610) 768-3300
Entity
Organization

Contact information

Practice address
3600 N PROW RD, BLOOMINGTON, IN 47404-1616
(812) 331-8000
(812) 331-8985
Mailing address
3600 N PROW RD, BLOOMINGTON, IN 47404-1616
(812) 331-8000
(812) 331-8985

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
324-1-PIP
IN
283Q00000X
Psychiatric Hospital
324-1-PIP
IN
363LF0000X
Family Nurse Practitioner
Primary
71000894A
IN
363LP0200X
Pediatric Nurse Practitioner
28152858A
IN
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
364SP0813X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060128000
MAGELLAN
IN
01
107936
ANTHEM
IN
05
200075480
IN
01
2398043
OHIO MEDICAID
OH
Enumeration date
11/02/2006
Last updated
04/13/2015
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