Individual
CORTNEY BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
15047 AIRLINE HWY, PRAIRIEVILLE, LA 70769-4201
(225) 744-8409
(225) 744-8411
Mailing address
15047 AIRLINE HWY, PRAIRIEVILLE, LA 70769-4201
(225) 744-8409
(225) 744-8411
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST021812
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699213173
PHARMACIST
LA
Enumeration date
12/02/2020
Last updated
12/02/2020
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