Provider Demographics
NPI:1174084412
Name:EVERNORTH DIRECT HEALTH LLC
Entity type:Organization
Organization Name:EVERNORTH DIRECT HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL ANALYSIS SENIOR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:COOLIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-277-1170
Mailing Address - Street 1:13975 BORG WARNER DRIVE
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-9421
Mailing Address - Country:US
Mailing Address - Phone:765-778-5900
Mailing Address - Fax:765-778-5905
Practice Address - Street 1:13975 BORG WARNER DRIVE
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-9421
Practice Address - Country:US
Practice Address - Phone:765-778-5900
Practice Address - Fax:765-778-5905
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVERNORTH DIRECT HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-28
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center