| NPI | 1578933313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI FELDMAN Medication Management Specialist 267-414-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: DE A1-0003985) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: PA 440842) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |