| NPI | 1265806350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON IGHO IDIARE Staff Pharmacist 615-852-6133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TN 0000011542) |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |