Active NPI
Candace L Bloomer, PHARMACIST
- Pharmacist
- Mableton, GA
National Provider Identifier
1013344357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 020336
- Practice address
- 5000 Floyd Rd SW
Mableton, GA 30126-1608 - Phone
- (318) 425-6280
- NPI assigned
- Oct 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 020336 | LA | Primary |
Addresses
Primary practice location
5000 Floyd Rd SW
Mableton, GA 30126-1608
Mailing address
1850 N Market St
Shreveport, LA 71107-5212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020336 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671840000000",
"number": "1013344357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 N MARKET ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711075212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 FLOYD RD SW",
"city": "MABLETON",
"state": "GA",
"postal_code": "301261608",
"telephone_number": "318-425-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOMER",
"first_name": "CANDACE",
"middle_name": "L",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-01",
"last_updated": "2022-12-24",
"certification_date": "2022-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "020336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mableton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.