| Evernorth Care Providers - Arizona Pc | |
|
1603 Capitol Ave Ste 510d Cheyenne WY 82001-4563 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Arizona Pc |
|---|---|
| Speciality | General Practice |
| Location | 1603 Capitol Ave Ste 510d, Cheyenne, Wyoming |
| Authorized Official Name and Position | Grace Blue (CREDENTIALING SR. MANAGER) |
| Authorized Official Contact | 7732924800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evernorth Care Providers - Arizona Pc 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Arizona Pc 1603 Capitol Ave Ste 510d Cheyenne WY 82001-4563 Ph: (773) 292-4800 |
| NPI Number | 1679336812 |
|---|---|
| Provider Enumeration Date | 01/31/2024 |
| Last Update Date | 01/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679336812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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