| Bloomwell Health Llc | |
|
128 S Tryon St Fl 18 Charlotte NC 28202-5001 | |
| (202) 688-5987 | |
| Not Available |
| Full Name | Bloomwell Health Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 128 S Tryon St Fl 18, Charlotte, North Carolina |
| Authorized Official Name and Position | Chinonye Egbulem (OWNER) |
| Authorized Official Contact | 2026885987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomwell Health Llc 128 S Tryon St Fl 18 Charlotte NC 28202-5001 Ph: () - | Bloomwell Health Llc 128 S Tryon St Fl 18 Charlotte NC 28202-5001 Ph: (202) 688-5987 |
| NPI Number | 1639907090 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 6002336740 |
|---|---|
| Medicare Enrollment ID | O20250225001022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639907090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Chinonye Donna Egbulem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952153231 PECOS PAC ID: 4284154931 Enrollment ID: I20250225001183 |
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