Organization
BLOOM IDAHO LLC
Active
Other names
AFC Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER SMITH (CEO)
(208) 853-3000
Entity
Organization
Contact information
Practice address
6965 N GLENWOOD ST, GARDEN CITY, ID 83714-1967
(208) 853-3000
Mailing address
50 HENRY ST, CORTEZ, CO 81321-3012
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
06/25/2019
Last updated
05/02/2022
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