Provider Demographics
NPI:1669250429
Name:HUMANA INSURANCE COMPANY
Entity type:Organization
Organization Name:HUMANA INSURANCE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MEDICARE AND MEDICAID
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RENAUDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-370-1801
Mailing Address - Street 1:1100 EMPLOYERS BLVD
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-8187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 EMPLOYERS BLVD
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-8187
Practice Address - Country:US
Practice Address - Phone:502-580-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization