Provider Demographics
NPI:1104101781
Name:HEALTHWAYS
Entity type:Organization
Organization Name:HEALTHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LOCAL RN CARE COORDINATORS
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERB
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:410-628-1258
Mailing Address - Street 1:11 FAWN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5654
Mailing Address - Country:US
Mailing Address - Phone:410-628-1258
Mailing Address - Fax:
Practice Address - Street 1:11 FAWN RIDGE CT
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-5654
Practice Address - Country:US
Practice Address - Phone:410-628-1258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR177713302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization