Organization
AMERIGROUP WASHINGTON, INC.
Active
Parent organization
AMERIGROUP CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERIGROUP CORPORATION
Authorized official
MR. DARYL EDMONDS (PRESIDENT)
(206) 674-4462
Entity
Organization
Contact information
Practice address
705 5TH AVENUE SOUTH, SUITE 300, SEATTLE, WA 98104
(206) 674-4462
Mailing address
705 5TH AVENUE SOUTH, SUITE 300, SEATTLE, WA 98104
(206) 674-4462
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
500653
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
603047676
—
WA
Enumeration date
03/20/2012
Last updated
12/07/2016
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