Organization
EVERNORTH DIRECT HEALTH LLC
Active
Other names
Johnston Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH SUE COOLIDGE (FINANCIAL ANALYSIS MANAGER)
(623) 277-1170
Entity
Organization
Contact information
Practice address
735 GREENVILLE AVE, BLDG D, JOHNSTON, RI 02919
(623) 277-1170
Mailing address
25500 N NORTERRA DR, PHOENIX, AZ 85085-8200
(623) 277-1170
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2018
Last updated
05/14/2021
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