Provider Demographics
NPI:1891086807
Name:COVENTRY HEALTH CARE WORKERS COMPENSATION, INC
Entity Type:Organization
Organization Name:COVENTRY HEALTH CARE WORKERS COMPENSATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IMPLEMENTATION MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-806-2116
Mailing Address - Street 1:PO BOX 660776
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0776
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5130 EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6346
Practice Address - Country:US
Practice Address - Phone:813-806-2116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty