Evernorth Direct Health LLC

Organization Active NPI Non-Pharmacy Dispensing Site · Sunnyvale, TX

NPI 1134552508 · NPPES record last updated May 3, 2021

Key facts

NPI
1134552508
Entity type
Organization (NPI type 2)
Primary specialty
Non-Pharmacy Dispensing Site 332900000X
License
AP121686 (TX)
Legal business name
EVERNORTH DIRECT HEALTH LLC
Practice address
199 Planters Rd
Sunnyvale, TX 75182-9601
Phone
(214) 309-3438
NPI assigned
Aug 20, 2013
Organization subpart
Yes
Parent organization (as reported)
MEDVANTX, INC.

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Evernorth Direct Health LLC (102 organizations share this tax ID)
Part of
Tri - State Medical Group Inc

Locations

199 Planters Rd
Sunnyvale, TX 75182
Phone (214) 309-3438

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X AP121686 TX Yes

Addresses

Primary practice location

199 Planters Rd
Sunnyvale, TX 75182-9601

Mailing address

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

Other names

  • Mohawk -Tx- Dal Tile Sunnyvale Doing business as

Other providers in Sunnyvale, TX

All providers in Sunnyvale, TX · Non-Pharmacy Dispensing Site in Texas

Sources for this page

Verify at the official NPI Registry.