| Evernorth Care Providers - Tennessee Pc | |
|
1040 Monarch St Fl 3 Lexington KY 40513-1852 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Tennessee Pc |
|---|---|
| Speciality | General Practice |
| Location | 1040 Monarch St Fl 3, Lexington, Kentucky |
| Authorized Official Name and Position | Grace V Blue (CREDENTIALING SR. MANAGER) |
| Authorized Official Contact | 7732924800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evernorth Care Providers - Tennessee Pc 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Tennessee Pc 1040 Monarch St Fl 3 Lexington KY 40513-1852 Ph: (773) 292-4800 |
| NPI Number | 1831979335 |
|---|---|
| Provider Enumeration Date | 10/02/2023 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 7911355532 |
|---|---|
| Medicare Enrollment ID | O20240103000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831979335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Cheryl Hilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184677742 PECOS PAC ID: 4082683651 Enrollment ID: I20240119001394 |
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