EVERGREEN HEALTH CENTER LLC (NPI# 1356839575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356839575 |
| Entity Type | Organization |
| Organization Name | EVERGREEN HEALTH CENTER LLC |
| Practice Address |
520 Route 8 Maite GU 96910 |
| Practice Telephone | 6719220118 |
| Practice Fax Number | 6714772464 |
| Mailing Telephone | 6719220118 |
| Mailing Fax Number | 6714723981 |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2020-03-29 |
| Authorized Official Name | JAYAR CALILUNG (CLINIC MANAGER) |
| Authorized Official Telephone | 6714888817 |
| Authorized Official Credential | MHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
520 ROUTE 8 |
| City | MAITE |
| State | GU |
| Zip Code | 96910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972076792 | Evergreen Pharmacy & Supplies LLC | Pharmacy | 520 Route 8, Maite, GU 96910 | 2019-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576230 | Bo Henry Marshall | Physician Assistant | 302 S Route 4 Ste 207, Hagatna, GU 96910 | 2020-07-28 |
| 1972133361 | Elizabeth Quilitis Camacho | Licensed Practical Nurse | 127 2nd St Ocean Vista Tiyan, Maite, GU 96910 | 2020-01-24 |
| 1588200497 | Carrie Margeson | Pharmacist | Bldg #50 Farenholt Ave, Tutuhan, GU 96910 | 2019-11-26 |
| 1265075188 | Amy C Romero | Counselor | 144 Afia Building Suite 201, Hagatna, GU 96910 | 2019-10-23 |
| 1710549589 | Carmela Santos | Registered Nurse | Bldg #50, Farenholt Ave, Tutuhan, GU 96910 | 2019-07-02 |
| 1912469404 | Daniel A. Duenas | Social Worker | 222 Chalan Santo Papa Reflection Center, Hagatna, GU 96910 | 2019-04-03 |
| 1598238891 | Steven Butler | Counselor | 144 Aspinal Ave., Afia Bld. Suite 202, Hagatna, GU 96910 | 2019-01-09 |
| 1790275675 | Evangeline Claassens | Nurse Practitioner | 736 South Route 4, Suite 103, Sinajana, GU 96910 | 2018-05-16 |
| 1902312382 | Sarah Burton | Pharmacist | Building 50 Farenholt Blvd, Agana Heights, GU 96910 | 2017-12-20 |
| 1689188377 | Westcare Pacific Islands | Counselor | 222 Chalan Santo Papa, Reflection Center Suite 102, Hagatna, GU 96910 | 2017-11-17 |
| Find all providers in zip 96910 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487031613 | Office of Leopoldo Arcilla, Jr.,md.,pc | Clinic/Center | 1757 Army Dr Ste 108, Tamuning, GU 96913-1260 | 2015-04-27 |
| 1942699640 | Isla Pediatrics, PC | Clinic/Center | 132 E Espirito St, Tamuning, GU 96913-3834 | 2015-01-19 |
| 1659816924 | The Doctors' Clinic | Clinic/Center | 851 Gov Carlos G Camacho Rd, Tamuning, GU 96913-3153 | 2016-12-22 |
Please comment or provide details below to improve the information on EVERGREEN HEALTH CENTER LLC.
| 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.