Provider Demographics
NPI:1801623608
Name:INGHAM HEALTH PLAN CORPORATION
Entity type:Organization
Organization Name:INGHAM HEALTH PLAN CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:NOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-336-3778
Mailing Address - Street 1:PO BOX 30125
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-7625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3425 BELLE CHASE WAY STE 1
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4201
Practice Address - Country:US
Practice Address - Phone:517-336-3778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INGHAM HEALTH PLAN CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-16
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty