# EVERNORTH DIRECT HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVERNORTH DIRECT HEALTH LLC
- **Other names:** Mohawk HLC Bridgeport
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245920131
- **Legal business name:** EVERNORTH DIRECT HEALTH LLC
- **Authorized official:** DEBORAH SUE COOLIDGE (FINANCIAL ANALYSIS SENIOR MANAGER)
- **Authorized official phone:** (623) 277-1170

## Contact information

- **Practice address:** 202 JACOBS AVE, BRIDGEPORT, AL 35740-6682
- **Practice address phone:** (256) 495-2928
- **Practice address fax:** (256) 495-2928
- **Mailing address:** 8888 E RAINTREE DR, SCOTTSDALE, AZ 85260-3951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/12/2023
- **Last updated:** 05/12/2023