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EVERNORTH DIRECT HEALTH LLC NPI 1609171917


NPI Information

NPI: 1609171917
Provider Name: EVERNORTH DIRECT HEALTH LLC

Doing Business As: MOHAWK HEALTHY LIFE CENTER AT ANTIOCH

Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization
Address:
2001 ANTIOCH RD
DALTON, GA
ZIP 30721
Phone: (706) 275-7660
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EVERNORTH DIRECT HEALTH LLC is a non pharmacy dispensing site in Dalton, GA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) EVERNORTH DIRECT HEALTH LLC NPI is 1609171917. The provider is registered as an organization entity type.
The provider Is Doing Business As Mohawk Healthy Life Center At Antioch.

The provider's business location address is:

2001 ANTIOCH RD
DALTON, GA
ZIP 30721-622
Phone: (706) 275-7660

The provider's authorized official is Kenny Heine .
The authorized official title is Vp Of Operations and has the following contact phone number (858) 625-2990.

The enumeration date for this NPI number is 1/18/2011 and was last updated on 5/3/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332900000XNon-Pharmacy Dispensing SiteRN213704GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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