| Specialty | Taxonomy Code | |
|---|---|---|
| * | Health Service | 261QH0100X |
| Mental Health (Including Community Mental Health Center) | 261QM0801X |
* Indicates primary specialty
| NPI Number | 1447140504 |
| Legal business name LBN |
BLOOM MED, LLC |
| Authorized official | MARK GOFORTH - (OWNER) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 07/08/2025 |
| Last updated | 07/08/2025 - About 11 months ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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