| NPI | 1790812410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ADLER EVP National Provider Services 757-412-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |