| NPI | 1710219340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL WAYNE HESTER Owner 229-245-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 9351) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2010-02-08 |