Organization
AMERIGROUP CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JMAES GORDEN CARLSON (PRESIDENT)
(757) 962-6452
Entity
Organization
Contact information
Practice address
4425 CORPORATION LN, VIRGINIA BEACH, VA 23462-3103
(757) 962-6452
(757) 222-2377
Mailing address
4425 CORPORATION LN, VIRGINIA BEACH, VA 23462-3103
(757) 962-6452
(757) 222-2377
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/28/2005
Last updated
08/22/2020
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