Evergreen Pharmacy

LBN: Evergreen Pharmacy, P.C.
Evergreen Pharmacy is an health care organization with primary practice located at 1222 Welsh Rd Suite# C-1, North Wales PA 19454-2054. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Evergreen Pharmacy, P.C. can be contacted via phone (215) 393-0902, or through Kim, Kwang-Sik via phone (215) 393-0902.

Contact Information

Primary practice address
1222 Welsh Rd Suite# C-1 North Wales PA 19454-2054
Phone: (215) 393-0902
Fax: (215) 393-0904
Website:
Map and Directions
Authorized official contact:
Name: Kim, Kwang-Sik R.PH.
Phone: (215) 393-0902

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PP481492 Pennsylvania

Profile Details

NPI number 1881720050
LBN Legal business name Evergreen Pharmacy, P.C.
DBA Doing business as Evergreen Pharmacy
Authorized official Kim, Kwang-Sik R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Feb 24th, 2007
Last updated Aug 31st, 2015 - about 9 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 1881720050 NPPES
Pennsylvania MEDICAID 1014115870001

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