Provider Demographics
NPI:1902369317
Name:UNITEDHEALTHCARE OF LOUISIANA, INC.
Entity Type:Organization
Organization Name:UNITEDHEALTHCARE OF LOUISIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER (C&S)
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:WAULTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-479-9819
Mailing Address - Street 1:3838 N. CAUSEWAY BLVD.
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-849-3521
Mailing Address - Fax:504-849-3570
Practice Address - Street 1:3838 N. CAUSEWAY BLVD.
Practice Address - Street 2:SUITE 2600
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-849-3521
Practice Address - Fax:504-849-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2376985Medicaid