# EVERNORTH DIRECT HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDVANTX, INC.
- **Other names:** MOHAWK HEALTHY LIFE CENTER AT ANTIOCH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609171917
- **Legal business name:** MEDVANTX, INC.
- **Authorized official:** KENNY HEINE (VP OF OPERATIONS)
- **Authorized official phone:** (858) 625-2990

## Contact information

- **Practice address:** 2001 ANTIOCH RD, DALTON, GA 30721-4622
- **Practice address phone:** (706) 275-7660
- **Mailing address:** 9276 SCRANTON RD, SUITE 100, SAN DIEGO, CA 92121-7701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | RN213704 | GA | Yes |

## Other

- **Enumeration date:** 01/18/2011
- **Last updated:** 05/03/2021