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NPI Code Detail

MEDICARE: CARESOURCE

MEDICARE: CARESOURCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance OrganizationOH

General Provider Information

NPI Number : 1548791916
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARESOURCE
Provider Business Mailing Address
First Line : 230 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-1263
Country : US
Telephone Number : 937-531-2200
Fax Number :
Provider Business Practice Location Address
First Line : 230 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-1263
Country : US
Telephone Number : 937-531-2200
Fax Number :
Authorized Official
Title or Position : CEO
Name : MS. PAMELA B. MORRIS
Credential :
Telephone Number : 937-531-2200
Provider Enumeration Date : 03/27/2017
Last Update Date : 03/27/2017

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Directions to “CARESOURCE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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