Healthcare Provider Details

I. General information

NPI: 1982919692
Provider Name (Legal Business Name): AETNA BETTER HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5615 CORPORATE BLVD STE 400B
BATON ROUGE LA
70808-2536
US

IV. Provider business mailing address

4645 E COTTON CENTER BLVD BLDG 1 ATTN: LEGAL DEPARTMENT
PHOENIX AZ
85040-4824
US

V. Phone/Fax

Practice location:
  • Phone: 573-355-0815
  • Fax: 602-344-7037
Mailing address:
  • Phone: 573-355-0815
  • Fax: 602-344-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: A.J. HERBERT
Title or Position: LAWYER
Credential:
Phone: 504-207-7310