EVERGREEN HEALTH, LLC (NPI# 1407403611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407403611 |
| Entity Type | Organization |
| Organization Name | EVERGREEN HEALTH, LLC |
| Practice Address |
29 Bowdoin St Manchester ME 04351-3554 |
| Practice Telephone | 2076224500 |
| Practice Fax Number | 2076225452 |
| Mailing Telephone | 2076224500 |
| Mailing Fax Number | 2076225452 |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |
| Authorized Official Name | ERIN BAKER (ACCOUNTS COORDINATOR) |
| Authorized Official Telephone | 2076624500 |
| Authorized Official Credential | BILLING ACCOUNT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Evregreen, Health LLC | Doing Business As Name - Organization |
| Street Address |
29 BOWDOIN ST |
| City | MANCHESTER |
| State | ME |
| Zip Code | 04351-3554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043216922 | Douglas Joseph Jorgensen | Neuromusculoskeletal Medicine & OMM | 29 Bowdoin St, Manchester, ME 04351-3554 | 2005-06-24 |
| 1326506395 | Christopher Curtis King | Nurse Practitioner | 29 Bowdoin St, Manchester, ME 04351-3554 | 2019-03-07 |
| 1598799132 | Suzanne Wentworth Meub | Nurse Practitioner | 29 Bowdoin St, Manchester, ME 04351-3554 | 2006-07-10 |
| 1730187923 | Northern New England Primary Care | Chiropractor | 29 Bowdoin St, Manchester, ME 04351 | 2005-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497171318 | Peter J Volk | Family Medicine | 23 Bowdoin Street, Manchester, ME 04351 | 2014-03-17 |
| 1740563428 | Insight-premier Health LLC | Clinic/Center | 27 Bowdoin Street, Manchester, ME 04351 | 2011-09-20 |
| 1427353069 | Robin Page Dufour | Physical Therapist | 6 Rockwood Dr, Suite 2, Manchester, ME 04351 | 2011-01-12 |
| 1174839708 | Richard Ofoe Kavi | Pharmacist | 943 Western Ave, Manchester, ME 04351 | 2010-08-20 |
| 1700199031 | Neil A Graves | Pharmacist | 943 Western Ave., Manchester, ME 04351 | 2010-07-15 |
| 1427212059 | Dustin R Sulak | Family Medicine | 964 Western Ave., Manchester, ME 04351 | 2008-07-14 |
| 1437312295 | Crossroads Counseling Center Pllc | Social Worker | 726 Western Ave., Manchester, ME 04351 | 2008-07-02 |
| 1548453616 | Christopher Paul Beaudoin | Social Worker | 15 Range Way Suite 3, Manchester, ME 04351 | 2007-08-22 |
| 1275724288 | Shawn Kenneth Hodgdon | Social Worker | 726 Western Avenue, Manchester, ME 04351 | 2007-08-05 |
| 1790900512 | Scott A Hayward | Social Worker | 15 Range Way, Suite 3, Manchester, ME 04351 | 2007-04-16 |
| Find all providers in zip 04351 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1891102497 | Recover Together, Inc. | Clinic/Center | 50 Bridge St Ste 101, Manchester, NH 03101-1633 | 2014-07-15 |
| 1033510961 | Memorial Hospital, Inc. | Clinic/Center | 65 Glenndale Rd, Suite 1, Manchester, KY 40962-6212 | 2014-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972015774 | Down East Community Hospital | Clinic/Center | 43 Palmer St Ste 1, Calais, ME 04619-1305 | 2017-11-02 |
| 1053752584 | New England Telemedicine Pa | Clinic/Center | 98 Route 236, Suite 2, Kittery, ME 03904-5527 | 2013-07-12 |
| 1609837236 | Goodall Health Partners | Clinic/Center | 27 June St, Sanford, ME 04073-2621 | 2006-03-31 |
| 1902422561 | Mainehealth | Clinic/Center | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2020-06-19 |
| 1801235023 | Penobscot Community Health Center | Clinic/Center | 6 Telcom Dr, Bangor, ME 04401-3072 | 2013-06-20 |
| 1871936609 | Southern Maine In Home Therapy Services,llc | Clinic/Center | 59 Sleepy Hollow Dr, Gorham, ME 04038-2563 | 2013-04-11 |
| 1467608836 | Mdfpr | Clinic/Center | 15 E Chestnut St, Augusta, ME 04330-5736 | 2008-08-17 |
| 1104005362 | Spurwink Services | Clinic/Center | 17 Bishop St, Portland, ME 04103-2659 | 2007-10-24 |
| 1568581882 | Children, Families and Communities, Inc. | Clinic/Center | 102 Main St, Ste. A, Ellsworth, ME 04605-1919 | 2007-03-28 |
| 1588725246 | C. V. Diagnostics, Inc. | Clinic/Center | 244 Kennedy Memorial Dr, Waterville, ME 04901-4538 | 2006-12-13 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 04351 |
Please comment or provide details below to improve the information on EVERGREEN HEALTH, 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.