Healthcare Provider Details
I. General information
NPI: 1821275728
Provider Name (Legal Business Name): HEALTH NET OF CONNECTICUT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2008
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
ONE FAR MILL CROSSING MAIL STOP: CT-900-02-07
SHELTON CT
06484-6121
US
IV. Provider business mailing address
ONE FAR MILL CROSSING MAIL STOP: CT-900-02-07
SHELTON CT
06484-6121
US
V. Phone/Fax
- Phone: 800-848-4747
- Fax: 610-768-0288
- Phone: 800-848-4747
- Fax: 610-768-0288
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PAUL
S.
LAMBDIN
Title or Position: PRESIDENT, HEALTH NET, NORTHEAST
Credential:
Phone: 203-225-8168