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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568434025 | NPPES |
| Oregon | MEDICAID | 213560 | |
| Oregon | Other | J8799-01 | |
| Oregon | Other | 610550200 | |
| Oregon | Other | 845023000 |
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