The Bleeding and Clotting Disorders Institute

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

054-017718 Issued in IL

Legal business name

THE BLEEDING AND CLOTTING DISORDERS INSTITUTE

Practice address

427 W Northmoor Rd
Peoria, IL 61614-3542

Phone

(309) 692-5337

Fax

(309) 693-3913

NPI assigned

Nov 1, 2013

Last updated

Jul 30, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Tarantino, M.D.NPI 1396731063

Title

Medical Director

Phone

(309) 692-5337

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

The Bleeding and Clotting Disorders Institute3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• The Bleeding and Clotting Disorders Institute

  • Pediatric Hematology & Oncology Physician
  • Peoria, IL
  • NPI 1528925666
  NPD tax ID
• The Bleeding and Clotting Disorders Institute

  • Pharmacy
  • Peoria, IL
  • NPI 1962783431
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael D Tarantino, MD

  • Pediatric Hematology & Oncology Physician
  • Peoria, IL
  • NPI 1396731063
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1639508567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143542",
            "telephone_number": "309-692-5337",
            "fax_number": "309-693-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143542",
            "telephone_number": "309-692-5337",
            "fax_number": "309-693-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLEEDING AND CLOTTING DISORDERS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-01",
        "last_updated": "2021-07-30",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "TARANTINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-692-5337",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "IL",
            "license": "054-017718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "398680716",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "7225372",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Darlene Tharp
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• The Bleeding and Clotting Disorders Institute
• The Bleeding and Clotting Disorders Institute
• The Bleeding and Clotting Disorders Institute
• The Center for Youth and Family Solutions
• The Fresh Beet Nutrition LLC
• The Lawson Group, LLC. (Active Way)
• The Loft Rehabilitation of Peoria LLC

• Specialty Pharmacy in Peoria, IL
• Providers in Peoria, IL by specialty
• Specialty Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.