Organization
EVERNORTH DIRECT HEALTH LLC
Active
Parent organization
MEDVANTX, INC.
Other names
MOHAWK HEALTHY LIFE CENTER - SUGAR VALLEY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
3032 SUGAR VALLEY RD, CALHOUN, GA 30701
(706) 624-4661
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
002147
GA
Other
Enumeration date
03/22/2012
Last updated
05/03/2021
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