| NPI | 1881970507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKO GUTHRIE Sr. Diabetes Management Specialist 347-501-1452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2018-05-25 |