Provider Demographics
NPI:1285902817
Name:AMERICAN HEALTHWAYS
Entity type:Organization
Organization Name:AMERICAN HEALTHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LOCAL CARE COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:II
Authorized Official - Credentials:RN
Authorized Official - Phone:301-570-4460
Mailing Address - Street 1:18100 HEADWATERS DR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1751
Mailing Address - Country:US
Mailing Address - Phone:301-570-4460
Mailing Address - Fax:
Practice Address - Street 1:18100 HEADWATERS DR
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1751
Practice Address - Country:US
Practice Address - Phone:301-570-4460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-10
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR193056163W00000X
CA459165163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty