EVERGREEN PHARMACEUTICAL OF CALIFORNIA, INC. (NPI# 1013026608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013026608 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PHARMACEUTICAL OF CALIFORNIA, INC. |
| Other Organization Name | OMNICARE OF SANTA ROSA #48218 |
| Practice Address |
879 2nd St Santa Rosa CA 95404-4621 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7075780399 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-03-01 |
| Authorized Official Name | SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Omnicare of Santa Rosa | Doing Business As Name - Organization |
| Omnicare of Santa Rosa #48218 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588734123 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 5601 Oberlin Dr, Suite 124, San Diego, CA 92121-3747 | 2006-11-09 |
| 1982773172 | Evergreen Pharmaceutical of California, Inc. | Durable Medical Equipment & Medical Supplies | 6643 Valjean Ave, Van Nuys, CA 91406-5817 | 2006-11-06 |
| 1356429369 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 850 S Guild Ave, Lodi, CA 95240-3170 | 2006-11-01 |
| 1871605105 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 20967 Cabot Blvd, Hayward, CA 94545-1155 | 2006-08-31 |
| 1679685994 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 13825 Cerritos Corporate Dr, Suite A 1 & A2, Cerritos, CA 90703-2471 | 2006-08-31 |
| 1821010729 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 8220 Remmet Ave, Canoga Park, CA 91304-4156 | 2006-07-23 |
| 1922040740 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 5200 Churn Creek Rd, Suite A, Redding, CA 96002-3930 | 2006-06-13 |
| Street Address |
879 2ND ST |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-4621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629604368 | Jafa Pharmaceuticals, Inc. | Pharmacy | 95 Montgomery Dr Ste 108, Santa Rosa, CA 95404-6617 | 2020-03-13 |
| 1619056660 | Rp Healthcare Inc | Pharmacy | 2456 W 3rd St, Santa Rosa, CA 95401-6425 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508465873 | Nskape Inc | Pharmacy | 6780 Indiana Ave Ste 145, Riverside, CA 92506-4270 | 2020-10-19 |
| 1770193641 | 986 Specialty Pharmacy Pasadena Inc | Pharmacy | 1719 E Walnut St, Pasadena, CA 91106-1611 | 2020-08-05 |
| 1356951370 | Valley Scripts | Pharmacy | 1150 W Robinhood Dr Ste 2b, Stockton, CA 95207-5630 | 2020-08-04 |
| 1518585587 | Asr Health Inc. | Pharmacy | 12677 Hesperia Rd Ste 180, Victorville, CA 92395-7754 | 2020-07-07 |
| 1619594660 | Burts Specialty Pharmacy | Pharmacy | 2628 Conejo Center Dr, Thousand Oaks, CA 91320-1407 | 2020-06-25 |
| 1972128676 | Maggie's Pharmacy Inc | Pharmacy | 2315 Kuehner Dr Ste 108, Simi Valley, CA 93063-3960 | 2020-06-09 |
| 1669019113 | Shanzo Inc | Pharmacy | 6255 University Ave Ste A1, San Diego, CA 92115-5727 | 2019-12-03 |
| 1265077283 | Western Pharmacy Group LLC | Pharmacy | 610 Gateway Center Way Ste H-i, San Diego, CA 92102-4533 | 2019-11-13 |
| 1083255129 | Desert Best Pharmacy, Inc. | Pharmacy | 170 E Tahquitz Canyon Way, Palm Springs, CA 92262-6431 | 2019-09-30 |
| 1538718838 | Xpress Med Pharmacy Inc | Pharmacy | 16929 Bushard St, Fountain Valley, CA 92708-2819 | 2019-09-09 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.