| NPI | 1801829403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMAINE GERARD TILLER Consultant Pharmacist 251-414-3050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AL 15106) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |