| NPI | 1881895100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUSAM MOHAMMAD NAZER Owner 304-253-0849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WV 13335) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2011-04-21 |