MOHAWK HEALTHY LIFE CENTER-GLASGOW
NPI 1467836163
Non-Pharmacy Dispensing Site in Glasgow, VA

Active since July 13, 2015CLIA 49D2091540 · Waiver
404 ANDERSON ST, GLASGOW, VA 24555(540) 258-7611 Get Directions Write a Review

NPPES record last updated: May 3, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mohawk Healthy Life Center-glasgow NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAWK HEALTHY LIFE CENTER-GLASGOW (NPI 1467836163) is a healthcare organization registered as a non-pharmacy dispensing site in Glasgow, Virginia and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through February 15, 2027 and lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1467836163
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameEVERNORTH DIRECT HEALTH LLC
Location Address404 ANDERSON STGlasgow, VA 24555-2802
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateJuly 13, 2015
Last NPPES UpdateMay 3, 2021
NPPES CertifiedMay 3, 2021
NPI 1467836163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License Licensed in VA · 0024171584
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
404 ANDERSON ST, Glasgow, VA 24555

Other Names 1

Doing Business AsMohawk Healthy Life Center-glasgow

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2091540

Healthy Life Center Glasgow Dba Evernorth Driect Health LLC · Glasgow, VA
Active · expires Feb 15, 2027
CLIA Number49D2091540
Laboratory TypeOutpatient
Certificate Effective DateFebruary 16, 2025
Certificate Expiration DateFebruary 15, 2027
Laboratory DirectorAino L. Floderus
Laboratory Phone(480) 868-0646
Laboratory LocationHealthy Life Center Glasgow Dba Evernorth Driect Health LLC404 Anderson Street, Glasgow, VA 24555
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center
404 ANDERSON ST
GLASGOW, VA 24555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evernorth Direct Health LLC's NPI number?

The NPI number for Evernorth Direct Health LLC is 1467836163. It was assigned to this organization in the NPPES registry on July 13, 2015. The provider is doing business as Mohawk Healthy Life Center-Glasgow.

Where is Evernorth Direct Health LLC located?

Evernorth Direct Health LLC is located at 404 Anderson St, Glasgow, VA 24555. The listed phone number is (540) 258-7611.

What is Evernorth Direct Health LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Evernorth Direct Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2091540) is associated with this NPI, valid through February 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Evernorth Direct Health LLC accept?

Health plans from Sanford Health Plan list Evernorth Direct Health LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Evernorth Direct Health LLC was last updated on May 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.