Golden Bloom Phrams Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

GOLDEN BLOOM PHRAMS INC

Practice address

1172 Old Salem Rd SE
Conyers, GA 30094-5944

Phone

(770) 633-8550

NPI assigned

Dec 3, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Lane

Title

President

Phone

(770) 633-8550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1962007252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 OLD SALEM RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945944",
            "telephone_number": "770-633-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 OLD SALEM RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945944",
            "telephone_number": "770-633-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN BLOOM PHRAMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-633-8550"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Global Diagnostic Services, Inc.
• Gisele Natacha Gobre, NP-C
• Rhys C. Godwin Sr.
• Robert E Going Jr., DDS
• Aaron Stanley Goldberg, M.D.
• Robert D. Golden, D.M.D.
• Yendi Nancy Gomes, NP-C
• Carl Gonzales II, M.D.
• Elizabeth Gonzales, LPN
• Debora Ann Goodrich, DO

• Exclusive Provider Organization in Conyers, GA
• Providers in Conyers, GA by specialty
• Exclusive Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.