Healthcare Provider Details

I. General information

NPI: 1316834963
Provider Name (Legal Business Name): EVERNORTH DIRECT HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 ALBERT PICK RD STE 400
GREENSBORO NC
27409-9519
US

IV. Provider business mailing address

8888 E RAINTREE DR
SCOTTSDALE AZ
85260-3951
US

V. Phone/Fax

Practice location:
  • Phone: 512-851-5330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH SUE COOLIDGE
Title or Position: FINANCIAL ANALYSIS SENIOR MANAGER
Credential:
Phone: 623-277-1170