EVERNORTH CARE PROVIDERS - TENNESSEE PC is a general practice in Fairfax, VA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Source: National Uniform Claim Committee EVERNORTH CARE PROVIDERS - TENNESSEE PC NPI is 1174304976. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
11350 RANDOM HILLS RD STE 800
FAIRFAX, VA
ZIP 22030-044
Phone: (773) 292-4800
Fax: (312) 564-4059
The provider's authorized official is Grace V Blue .
The authorized official title is Credentialing Sr. Manager and has the following contact phone number (773) 292-4800.
The CLIA number assigned to this NPI record is 49D2300070 - other - in home primary care with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/9/2023 and was last updated on 2/14/2024.