Healthcare Provider Details

I. General information

NPI: 1770985905
Provider Name (Legal Business Name): EVERSANA LIFE SCIENCE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17877 CHESTERFIELD AIRPORT RD
CHESTERFIELD MO
63005-1211
US

IV. Provider business mailing address

17877 CHESTERFIELD AIRPORT RD
CHESTERFIELD MO
63005-1211
US

V. Phone/Fax

Practice location:
  • Phone: 833-589-1607
  • Fax: 866-449-8449
Mailing address:
  • Phone: 636-519-2400
  • Fax: 877-473-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TRACY BAIRD
Title or Position: SR. DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 513-285-1890