Provider Demographics
NPI:1245814458
Name:MAGELLAN HEALTHCARE, INC.
Entity type:Organization
Organization Name:MAGELLAN HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR, SERVICE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-459-6159
Mailing Address - Street 1:PO BOX 20520
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7012
Mailing Address - Country:US
Mailing Address - Phone:307-459-6159
Mailing Address - Fax:
Practice Address - Street 1:14100 MAGELLAN PLZ
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-4644
Practice Address - Country:US
Practice Address - Phone:307-459-6159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health