# EVERNORTH DIRECT HEALTH LLC

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

## Provider details

- **NPI number:** 1649563230
- **Legal business name:** MEDVANTX, INC.
- **Authorized official:** KENNY HEINE (VP OF OPERATIONS)
- **Authorized official phone:** (858) 625-2990

## Contact information

- **Practice address:** 450 CLARENCE KING PKWY, CALHOUN, GA 30701-3628
- **Practice address phone:** (706) 624-3695
- **Mailing address:** 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 005483 | GA | Yes |

## Other

- **Enumeration date:** 05/16/2011
- **Last updated:** 05/03/2021