Organization
BLOOM NEW MEXICO LLC
Active
Organization
BLOOM NEW MEXICO LLC
Active
Other names
American Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER SMITH (CEO)
(970) 565-1919
Entity
Organization
Contact information
Practice address
2930 E MAIN ST, FARMINGTON, NM 87402-7624
(505) 326-6000
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
05/06/2020
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