Organization · Type 2 NPI

Evernorth Direct Health LLC

Clinic/Center · Rome, GA

NPI number 1760188056 Active

Practice location

420 Lavender Dr NW
Rome, GA 30165-2262

Call (706) 235-4316 Map

Fax (706) 235-4984

Mailing address

8888 E Raintree Dr
Scottsdale, AZ 85260-3951

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Other clinic/center providers in Rome

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NPI record

NPI: 1760188056
Entity type: Organization (Type 2)
Issued: Feb 7, 2023
Last updated: Feb 7, 2023
Status: Active
Subpart: Yes of Evernorth Direct Health LLC

Other names

Mohawk HLC Lavender · other name

Authorized official

Deborah Sue Coolidge
Financial Analysis Senior Manager
(623) 277-1170

Verify this record

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 1760188056

Evernorth Direct Health LLC's National Provider Identifier is 1760188056, issued on Feb 7, 2023. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Rome, GA. The record was last updated on Feb 7, 2023.