Al Bloomsburg Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

090002 Issued in PA

Legal business name

AL BLOOMSBURG OPERATIONS LLC

Practice address

3298 Ridge Rd
Bloomsburg, PA 17815-7932

Phone

(570) 784-6688

Fax

(570) 389-9081

NPI assigned

Oct 26, 2005

Organization subpart

No

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

Authorized official

Name

William Patrick Mulloy II

Title

President

Phone

(502) 753-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Balanced Care Bloomsburg Doing business as

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861482283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 ORMSBY STATION ROAD",
            "address_2": "SUITE 101 SENIOR CARE INC",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-753-6000",
            "fax_number": "502-753-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3298 RIDGE RD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178157932",
            "telephone_number": "570-784-6688",
            "fax_number": "570-389-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AL BLOOMSBURG OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULLOY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-753-6000",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "090002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016927160003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balanced Care Bloomsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Summer Ackerley
• Alejandro E. Acle, M.D.
• Colleen L Acor, MSW
• Tammy Adams
• Dany Ajlani, DMD
• Karlea Allen
• Alpha Supply and Services
• Betty J Amarante, LPC
• Adae Opoku Amoako, M.D.
• Rebecca Jane Anderson, CNM

• Skilled Nursing Facility in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.