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General NPI Number Information
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NPI Number | 1144369232
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Entity Type | Organization
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Legal Business Name | UNITED HEALTHCARE
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3720 DAVINCI CT
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City | NORCROSS
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State | GA
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Zip | 30092-7627
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Country | US
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Telephone | 770-582-4484
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Fax |
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Provider Business Mailing Address
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Address Line | 207 CRESTMONT WAY
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City | CANTON
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State | GA
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Zip | 30114-8875
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Country | US
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Telephone | 678-493-7374
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Fax |
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Authorized Official
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Title or Position | HEALTH SERVICES DIRECTOR
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Name | MRS. JILL J PAGANO
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Credential | NP
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Telephone | 770-582-3985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | RN174554 NP
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License Number State | GA
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