| NPI | 1477004125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY EHLE Clinical Authorizations Coordinator 800-546-5677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NE 13263) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |