Provider Demographics
NPI:1881201416
Name:BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS
Entity Type:Organization
Organization Name:BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-538-0454
Mailing Address - Street 1:7700 FORSYTH BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1807
Mailing Address - Country:US
Mailing Address - Phone:855-538-0454
Mailing Address - Fax:
Practice Address - Street 1:7700 FORSYTH BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1807
Practice Address - Country:US
Practice Address - Phone:855-538-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization