Evernorth Direct Health LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

RS00674900 Issued in NJ

Legal business name

EVERNORTH DIRECT HEALTH LLC

Practice address

801 Boardwalk
Atlantic City, NJ 08401-7509

Phone

(609) 343-4188

Fax

(609) 343-4214

NPI assigned

Oct 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sarju Patel, RPH

Title

Pharmacy Area Manager

Phone

(623) 277-1168

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• COH, LLC dba CIGNA Rx, a wholly owned subsidiary of CGLIC Other name

Tax ID family

Evernorth Direct Health LLC102 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Evernorth Direct Health LLC

  • Clinic/Center
  • Franklin Lakes, NJ
  • NPI 1154131092
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Evernorth Direct Health LLC

  • Clinic/Center
  • Franklin Lakes, NJ
  • NPI 1154131092
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1013106939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BOARDWALK",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084017509",
            "telephone_number": "609-343-4188",
            "fax_number": "609-343-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BOARDWALK",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084017509",
            "telephone_number": "609-343-4188",
            "fax_number": "609-343-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERNORTH DIRECT HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SARJU",
        "authorized_official_title_or_position": "PHARMACY AREA MANAGER",
        "authorized_official_telephone_number": "623-277-1168",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "RS00674900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ BOARD OF PHARMACY PERM",
            "identifier": "RS00674900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COH, LLC dba CIGNA Rx, a wholly owned subsidiary of CGLIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "COH, LLC dba CIGNA Rx, a wholly owned subsidiary of CGLIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Marie Farnsworth
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• Michael Domenic Farreny, PMHNP

• Health Maintenance Organization in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Health Maintenance Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.