| NPI | 1417417718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DONALD FRICKE Director Of Market Performance 317-822-7320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-03-22 |