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BLOOMINGTON MEDICAL DISTRIBUTION LLC NPI 1669918009


NPI Information

NPI: 1669918009
Provider Name: BLOOMINGTON MEDICAL DISTRIBUTION LLC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 14D2173863

Address:
1111 TRINITY LN
SUITE 111
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 306-7574
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BLOOMINGTON MEDICAL DISTRIBUTION LLC is a durable medical equipment medical supplies in Bloomington, IL. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. BLOOMINGTON MEDICAL DISTRIBUTION LLC NPI is 1669918009. The provider is registered as an organization entity type.

The provider's business location address is:

1111 TRINITY LN
SUITE 111
BLOOMINGTON, IL
ZIP 61704-111
Phone: (309) 306-7574

The provider's authorized official is Melissa Redondo .
The authorized official title is General Counsel and has the following contact phone number (309) 306-7574.

The CLIA number assigned to this NPI record is 14D2173863 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 1/9/2017 and was last updated on 5/6/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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