| NPI | 1164669289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA WARREN BROCK Executive Director 336-473-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2009-01-12 |