Evergreen Diagnostics, Llc

LBN: Evergreen Diagnostics, Llc
Evergreen Diagnostics, Llc is an health care organization with primary practice located at 2570 Nw Edenbower Blvd Suite 100, Roseburg OR 97470-6220. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Radiology, Laboratories / Clinical Medical Laboratory. Laboratories / Clinical Medical Laboratory is the primary health care specialty. Evergreen Diagnostics, Llc can be contacted via phone (541) 229-3311, or through Powell, Timothy via phone (541) 229-3301.

Contact Information

Primary practice address
2570 Nw Edenbower Blvd Suite 100 Roseburg OR 97470-6220
Phone: (541) 229-3311
Fax: (541) 229-3327
Website:
Map and Directions
Authorized official contact:
Name: Powell, Timothy Doctor of Medicine (MD)
Phone: (541) 229-3301

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1568434025
LBN Legal business name Evergreen Diagnostics, Llc
DBA Doing business as
Authorized official Powell, Timothy Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 7th, 2006
Last updated Dec 11th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568434025 NPPES
Oregon MEDICAID 213560
Oregon Other J8799-01
Oregon Other 610550200
Oregon Other 845023000

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