BLAQOUT INC. NPI 1750072849

NPI Information

NPI: 1750072849
Provider Name: BLAQOUT, INC.
Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

CLIA Number: 26D2240659

Address:
517 CAMPBELL ST
KANSAS CITY, MO
ZIP 64106
Phone: (816) 866-0355
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BLAQOUT, INC. is a community health clinic center in Kansas City, MO. BLAQOUT, INC. NPI is 1750072849. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

517 CAMPBELL ST
KANSAS CITY, MO
ZIP 64106-213
Phone: (816) 866-0355

The provider's authorized official is D. Rashaan Gilmore .
The authorized official title is Founder/ceo and has the following contact phone number (816) 866-0355.

The CLIA number assigned to this NPI record is 26D2240659 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2023 and was last updated on 5/18/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207QA0505X	Family Medicine	Adult Medicine	No
2	261Q00000X	Clinic/Center		No
3	261QP2300X	Clinic/Center	Primary Care	No
4	261QC1500X	Clinic/Center	Community Health	Yes

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: 5/5/2024

NPI Synchronization or Removal

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