Organization
BLOSSOM PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VICE PRESIDENT)
(337) 609-1221
Entity
Organization
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-8000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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