NPI 1609286145

Illuminated Direction

Organisation Health Maintenance Organization Durham, NC

Practice location

Address: 800 N Mangum St STE 104, Durham, NC 27701-2260
Phone: (919) 450-6446
Fax: (888) 227-5443
Mailing address: 2628 Camellia Dr APT C, Durham, NC 27705-2054

Authorised official

Name: Jonathan Dalandish Lacewell
Title: Owner
Phone: (919) 452-7931

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

Other Health Maintenance Organization providers in North Carolina →

Registry record

NPI: 1609286145
Entity type: Organization
NPI issued: 6 May 2014
Record last updated: 6 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.