EVERGREEN PHARMACEUTICAL, LLC (NPI# 1235240391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235240391 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PHARMACEUTICAL, LLC |
| Other Organization Name | OMNICARE OF PORTLAND #48329 |
| Practice Address |
11933 Ne Glenn Widing Dr Portland OR 97220-9099 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5032541647 |
| Practice Fax Number | 5032628763 |
| 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 Portland #48329 | 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 |
| 1780795765 | Evergreen Pharmaceutical, LLC | Pharmacy | 259 E Barnett Rd Ste L, Medford, OR 97501-7953 | 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 |
11933 NE GLENN WIDING DR |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-9099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| 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 |
|---|---|---|---|---|
| 1912017906 | Pharmerica East LLC | Pharmacy | 97 Mcalister Farm Rd, Portland, ME 04103 | 2006-08-30 |
| 1215976014 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2006-06-06 |
| 1063038826 | Bordonaro's Pharmacy Inc. | Pharmacy | 283 Main St, Portland, CT 06480-1856 | 2020-06-17 |
| 1235201997 | Bordonaro's Pharmacy Inc. | Pharmacy | 283 Main St, Portland, CT 06480-1856 | 2006-11-15 |
| 1336223171 | Providence Health & Services - Oregon | Pharmacy | 6410 Ne Halsey St, Suite 400, Portland, OR 97213-4742 | 2006-10-25 |
| 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 |
| 1780795765 | Evergreen Pharmaceutical, LLC | Pharmacy | 259 E Barnett Rd Ste L, Medford, OR 97501-7953 | 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.