EVERGREEN SHOP PHARMACY INC (NPI# 1083067995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083067995 |
| Entity Type | Organization |
| Organization Name | EVERGREEN SHOP PHARMACY INC |
| Other Organization Name | EVERGREEN SHOP PHARMACY |
| Practice Address |
150 S Grand Ave Ste K Glendora CA 91741-4715 |
| Practice Telephone | 6263352442 |
| Practice Fax Number | 6263350220 |
| Mailing Telephone | 6263352442 |
| Mailing Fax Number | 6263350220 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-08-10 |
| Authorized Official Name | MANAL KEST (CORPARATION OFFICER) |
| Authorized Official Telephone | 3108663415 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
54456 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2162500 | 01 |
| Other Name | Type Code |
|---|---|
| Evergreen Shop Pharmacy | Doing Business As Name - Organization |
| Street Address |
150 S GRAND AVE STE K |
| City | GLENDORA |
| State | CA |
| Zip Code | 91741-4715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083244016 | Monica Keo | Psychiatry & Neurology | 501 South Grand Avenue, #200, Glendora, CA 91741 | 2020-01-17 |
| 1871144816 | Djpnicolas, LLC | Clinic/Center | 144 N. Grand Avenue, Glendora, CA 91741 | 2019-09-20 |
| 1518517192 | Ashlyn Kate Cherry | Social Worker | 916 W. Danton Drive, Glendora, CA 91741 | 2019-09-16 |
| 1497284889 | Maged Guirguis | Private Vehicle | 1262 E Ada Ave, Glendora, CA 91741 | 2017-06-08 |
| 1952793200 | Dignity Transportation Service Inc | Private Vehicle | 255 S Glendora Ave #1613, Glendora, CA 91741 | 2015-02-24 |
| 1437568029 | Arakelyan Aznavour Dental Corporation | Dentist | 175 N Pennsylvania Ave #3, Glendora, CA 91741 | 2014-08-07 |
| 1528481223 | Lucinda Lorraine Schoenick | Nurse Practitioner | 250 S. Grand Ave, Glendora, CA 91741 | 2014-01-31 |
| 1073837548 | Advanced Dental Smiles | Dentist | 455 W. Foothill Blvd, Glendora, CA 91741 | 2010-03-26 |
| 1346404621 | Amee Brown | Occupational Therapist | 401 W. Ada Ave., Glendora, CA 91741 | 2008-07-15 |
| 1356539183 | Orthopaedic Medical Group | Specialist | 412 W Carroll St, Ste 107, Glendora, CA 91741 | 2007-10-05 |
| Find all providers in zip 91741 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1306881214 | Garfield Beach Cvs LLC | Pharmacy | 435 E Arrow Hwy, Glendora, CA 91740-5607 | 2006-06-17 |
| 1053378414 | Dsl Drugs Inc | Pharmacy | 159 N Glendora Ave, Glendora, CA 91741-3342 | 2006-04-28 |
| 1326158528 | Bones Management, Inc. | Pharmacy | 210 S Grand Ave, Suite 116, Glendora, CA 91741-4205 | 2006-08-30 |
| 1801906029 | Foothill Medical Plaza Pharmacy, Inc. | Pharmacy | 415 W Route 66, Glendora, CA 91740-4335 | 2006-08-30 |
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| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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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.