EVERGREEN PHARMACEUTICAL, LLC (NPI# 1780795765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780795765 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PHARMACEUTICAL, LLC |
| Other Organization Name | OMNICARE OF MEDFORD |
| Practice Address |
259 E Barnett Rd Ste L Medford OR 97501-7953 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5417795627 |
| Practice Fax Number | 5417790377 |
| 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 Medford | Doing Business As Name - Organization |
| Omnicare of Medford #48328 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255433447 | Evergreen Pharmaceutical, LLC | Pharmacy | 1751 Circle Ln Se, Lacey, WA 98503-2570 | 2006-09-01 |
| 1750492617 | Evergreen Pharmaceutical, LLC | Pharmacy | 350 E 3rd Ave, Spokane, WA 99202-1413 | 2006-08-31 |
| 1982715124 | Evergreen Pharmaceutical, LLC | Pharmacy | 12674 Gateway Dr S, Tukwila, WA 98168-3307 | 2006-08-31 |
| 1235240391 | Evergreen Pharmaceutical, LLC | Pharmacy | 11933 Ne Glenn Widing Dr, Portland, OR 97220-9099 | 2006-08-31 |
| 1982746897 | Evergreen Pharmaceutical, LLC | Durable Medical Equipment & Medical Supplies | 12220 113th Ave Ne, Suite 1000, Kirkland, WA 98034-6915 | 2007-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | EVERGREEN PHARMACEUTICAL, LLC | 900 Omnicare Center, 201 East Fourth Street, Cincinnati, OH 45202 |
| Washington State Corporations | EVERGREEN PHARMACEUTICAL, LLC | 1600 Rivercenter Blvd, Covington, KY 41011 |
| Street Address |
259 E BARNETT RD STE L |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-7953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| 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 |
|---|---|---|---|---|
| 1013132430 | Aspirus Medford Hospital & Clinics, Inc. | Pharmacy | 139 S Gibson St, Medford, WI 54451 | 2007-04-13 |
| 1093879439 | Aspirus Medford Hospital & Clinics, Inc. | Pharmacy | 135 S Gibson St, Medford, WI 54451-1622 | 2006-12-20 |
| 1740226836 | The Estaugh | Pharmacy | 1 Medford Leas, Medford, NJ 08055-2254 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023440864 | Olson Pharmacy Services | Pharmacy | 617 Monroe St, Oregon City, OR 97045-2336 | 2013-08-03 |
| 1861773798 | Grants Pass Pharmacy, Inc. | Pharmacy | 414 Sw 6th St., Grants Pass, OR 97526-2810 | 2011-09-06 |
| 1003051558 | Howard's Pharmacy Inc. | Pharmacy | 101 N F St, Lakeview, OR 97630-1529 | 2008-12-12 |
| 1558448225 | Pill Box Drugs Inc | Pharmacy | 635 N Arrowleaf Trl, Sisters, OR 97759 | 2006-11-01 |
| 1881776722 | Quisenberry Pharmacies Inc. | Pharmacy | 150 Liberty St Se, Salem, OR 97301-3506 | 2006-10-19 |
| 1093808198 | Pill Box Drugs Inc | Pharmacy | 906 Nw Kings Blvd, Corvallis, OR 97330 | 2006-10-02 |
| 1871690719 | Pill Box Drugs Inc | Pharmacy | 910 Nw Kings Blvd, Corvallis, OR 97330-2505 | 2006-09-20 |
| 1952405664 | Dept. of Human Srvcs/office of Fin. Srvcs Dba Irs/eopc/eotc/osh/osh-p | Pharmacy | 2600 Westgate, Pendleton, OR 97801-9604 | 2006-09-12 |
| 1235240391 | Evergreen Pharmaceutical, LLC | Pharmacy | 11933 Ne Glenn Widing Dr, Portland, OR 97220-9099 | 2006-08-31 |
| 1316966484 | Eppik Inc | Pharmacy | 201 Villa Rd Ste A, Newberg, OR 97132-1828 | 2006-07-19 |
| 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.