Organization · Type 2 NPI

Evernorth Direct Health LLC

Non-Pharmacy Dispensing Site · Sunnyvale, TX

NPI number 1134552508 Active

Practice location

199 Planters Rd
Sunnyvale, TX 75182-9601

Call (214) 309-3438 Map

Mailing address

9276 Scranton Rd, Suite 100
San Diego, CA 92121-7701

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	AP121686 (TX)

Non-Pharmacy Dispensing Site: 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.)

Another provider at this address

Evernorth Direct Health LLCClinic/Center Sunnyvale, TX NPI 1114645819

NPI record

NPI: 1134552508
Entity type: Organization (Type 2)
Issued: Aug 20, 2013
Last updated: May 3, 2021
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

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Mohawk -Tx- Dal Tile Sunnyvale · doing business as
Mohawk -Tx- Dal Tile Sunnyvale · doing business as

Authorized official

Kenny Heine
VP of Operations
(858) 964-1506

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1134552508

Evernorth Direct Health LLC's National Provider Identifier is 1134552508, issued on Aug 20, 2013. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Sunnyvale, TX. The record was last updated on May 3, 2021.