Provider Demographics
NPI:1770985905
Name:EVERSANA LIFE SCIENCE SERVICES, LLC
Entity type:Organization
Organization Name:EVERSANA LIFE SCIENCE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR ACCESS & REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RESTREPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-285-1889
Mailing Address - Street 1:17877 CHESTERFIELD AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1211
Mailing Address - Country:US
Mailing Address - Phone:636-519-2400
Mailing Address - Fax:866-862-8818
Practice Address - Street 1:17877 CHESTERFIELD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1211
Practice Address - Country:US
Practice Address - Phone:833-589-1607
Practice Address - Fax:866-449-8449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140001853336C0003X, 3336C0003X
3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2014000185OtherBOARD OF PHARMACY
MO2014000185OtherBOARD OF PHARMACY
MO2014000185OtherBOARD OF PHARMACY