| Evernorth Care Providers - Tennessee PC | |
|
301 Main St Ste 2200 Baton Rouge LA 70801-0014 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Tennessee PC |
|---|---|
| Speciality | General Practice |
| Location | 301 Main St Ste 2200, Baton Rouge, Louisiana |
| 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 301 Main St Ste 2200 Baton Rouge LA 70801-0014 Ph: (773) 292-4800 |
| NPI Number | 1215717319 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 02/14/2024 |
| Certification Date | 02/14/2024 |
| Medicare PECOS PAC ID | 7911355532 |
|---|---|
| Medicare Enrollment ID | O20240313003794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215717319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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