| NPI | 1023944287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA B CUMMINGS EVP. Chief Operating Officer 840-983-6234 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2026-06-23 |
| Last Update Date | 2026-06-23 |