Organization
BLOOM VISION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY SAVIDGE (BILLING CLERK)
(570) 387-8800
Entity
Organization
Contact information
Practice address
301 EAST ST, BLOOMSBURG, PA 17815-1846
(570) 387-8800
(570) 784-8887
Mailing address
301 EAST ST, BLOOMSBURG, PA 17815-1846
(570) 387-8800
(570) 784-8887
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02497000
CAPITAL BLUE CROSS
PA
01
—
436035
KEYSTONE HEALTH PLAN CENT
PA
Enumeration date
07/14/2005
Last updated
07/21/2022
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