EVERGREEN PHARMACEUTICAL OF CALIFORNIA, INC. (NPI# 1679685994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679685994 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PHARMACEUTICAL OF CALIFORNIA, INC. |
| Other Organization Name | OMNICARE OF CERRITOS |
| Practice Address |
13825 Cerritos Corporate Dr Suite A 1 & A2 Cerritos CA 90703-2471 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5622293500 |
| Practice Fax Number | 5622293595 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-08-31 |
| 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 Cerritos | Doing Business As Name - Organization |
| Omnicare of Cerritos #48211 | 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 |
| 1013026608 | Evergreen Pharmaceutical of California, Inc. | Pharmacy | 879 2nd St, Santa Rosa, CA 95404-4621 | 2006-08-29 |
| 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 |
13825 CERRITOS CORPORATE DR SUITE A 1 & A2 |
| City | CERRITOS |
| State | CA |
| Zip Code | 90703-2471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881145209 | Andrew Tawfik | Pharmacist | 13825 Cerritos Corporate Dr, Cerritos, CA 90703-2471 | 2016-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909582 | Michael Wong Dental Corporation | Dentist | 11549 South Street, Cerritos, CA 90703 | 2020-10-15 |
| 1144837139 | Essential California Ipa Inc. | Health Maintenance Organization | 1800 Studebaker Rd., 100, Cerritos, CA 90703 | 2020-09-24 |
| 1447868377 | Auxilium Health Network, Inc. | Health Maintenance Organization | 18000 Studebaker Dr, Cerritos, CA 90703 | 2020-07-16 |
| 1154939098 | Absolute Medical Partners, A Professional Medical Corporation | Health Maintenance Organization | 18000 Studebaker Rd., Ste 100, Cerritos, CA 90703 | 2020-07-16 |
| 1558906487 | Vitruvian Care, Inc. | Health Maintenance Organization | 18000 Studebaker Road Suite 100, Cerritos, CA 90703 | 2019-11-14 |
| 1841843554 | Ha Tran Tsai Dental Corporation | Dentist | 16466 Norwalk Boulevard, Cerritos, CA 90703 | 2019-07-22 |
| 1457828097 | Angela Ofoegbu | Registered Nurse | 10733 Elgers St, Cerritos, CA 90703 | 2018-11-01 |
| 1689183352 | Zeela G Diwa | Occupational Therapist | 12736 Palm Street, Cerritos, CA 90703 | 2017-09-26 |
| 1114446119 | Cooper Lee | Physical Therapist | 18503 Noran Ave, Cerritos, CA 90703 | 2017-09-12 |
| 1295259141 | Miyeon Vivienne Lee | Nurse Practitioner | 13337 South Street #158, Cerritos, CA 90703 | 2017-08-02 |
| Find all providers in zip 90703 | ||||
| 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] |
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| 1508465873 | Nskape Inc | Pharmacy | 6780 Indiana Ave Ste 145, Riverside, CA 92506-4270 | 2020-10-19 |
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| 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 |
| 1629604368 | Jafa Pharmaceuticals, Inc. | Pharmacy | 95 Montgomery Dr Ste 108, Santa Rosa, CA 95404-6617 | 2020-03-13 |
| 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 |
| 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.