NPI | 1457535056 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERRY ROBERTS Director, Managed Care 601-605-2023 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MS 9923719) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2007-12-19 |