Organization · Type 2 NPI

Evergreen Pharmaceutical of California, LLC

Long Term Care Pharmacy · Lodi, CA

NPI number 1356429369 Active

Practice location

850 S Guild Ave
Lodi, CA 95240-3170

Call (209) 333-4900 Map

Fax (209) 333-3601

Mailing address

1 Cvs Dr, Box 1075
Woonsocket, RI 02895-6146

Specialties and licenses

Taxonomy	Code	License
Long Term Care Pharmacy Primary	3336L0003X	None listed

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, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

3 other providers at this address

Other long term care pharmacy providers in Lodi

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NPI record

NPI: 1356429369
Entity type: Organization (Type 2)
Issued: Nov 1, 2006
Last updated: Jan 4, 2021
Status: Active

Other names

<unavail>
Omnicare of Northern California · doing business as
Omnicare of Northern California #48214 · doing business as

Authorized official

Susan Colbert
SR Director, Payer Relations
(401) 770-2751

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1356429369

Evergreen Pharmaceutical of California, LLC's National Provider Identifier is 1356429369, issued on Nov 1, 2006. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in Lodi, CA. The record was last updated on Jan 4, 2021.