Organization
PREMIUM UNITED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA NNADI (CLINICAL ADMINISTRATOR)
(214) 909-9091
Entity
Organization
Contact information
Practice address
2925 TRADITION AVE, BATON ROUGE, LA 70810-0336
(866) 540-6972
Mailing address
2925 TRADITION AVE, BATON ROUGE, LA 70810-0336
(866) 540-6972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
202997
LA
Other
Enumeration date
05/07/2013
Last updated
05/07/2013
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