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Evernorth Direct Health LLC — NPI 1578831665, Lyerly, GA | NPI Central

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NPI 1578831665

OrganizationActive

Evernorth Direct Health LLC

NPI 1578831665 · Non-Pharmacy Dispensing Site · Lyerly, GA

Provider details

NPI number: 1578831665
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Organization subpart: Yes
Authorized official: Kenny Heine, Vp of Operations(858) 625-2990
License: 004110 (GA)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense 004110 (GA)
Suppliers

Practice location

5081 Highway 114

Lyerly, GA 30730-4585

Phone: (800) 241-4900

Approximate (ZIP-level) locationGet directions

More GA providers

Mailing address

9276 Scranton Rd

San Diego, CA 92121-7701

Other names (DBA / former)

Doing business as: Mohawk Healthy Life Center - Lyerly
Doing business as: Mohawk Healthy Life Center - Lyerly

Registry dates

Enumerated: 2011-12-05
Last updated: 2021-05-03
Certified: 2021-05-03

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.