NPI | 1962643312 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY LEE FOZZARD President/CEO 800-896-0442 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IN 08-007377-1) |
Enumeration Date | 2009-03-16 |
Last Update Date | 2009-03-16 |