Organization
BRIDGEWAY HEALTH SOLUTIONS
Active
Parent organization
CENTENE
Other names
Centene Corporation
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTENE
Authorized official
NICOLE LARSON VP, (COMPLIANCE OFFICER)
(866) 475-3129
Entity
Organization
Contact information
Practice address
1501 W FOUNTAINHEAD PKWY, SUITE 201, TEMPE, AZ 85282-1868
(866) 475-3129
(866) 687-0515
Mailing address
1501 W FOUNTAINHEAD PKWY, SUITE 201, TEMPE, AZ 85282-1868
(866) 475-3129
(866) 687-0515
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1283
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231241
—
AZ
Enumeration date
01/25/2011
Last updated
01/25/2011
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