Provider Demographics
NPI:1427511583
Name:HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.
Entity type:Organization
Organization Name:HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, RETAIL SEGMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-580-2003
Mailing Address - Street 1:500 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2946
Mailing Address - Country:US
Mailing Address - Phone:502-580-1492
Mailing Address - Fax:
Practice Address - Street 1:1 GALLERIA BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2082
Practice Address - Country:US
Practice Address - Phone:502-580-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMANA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-07
Last Update Date:2019-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization