EVERGREEN PHARMACY INC (NPI# 1861852030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861852030 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PHARMACY INC |
| Practice Address |
2365 Quimby Rd Ste 150 San Jose CA 95122-1337 |
| Mailing Address |
Evergreen Pharmacy Po Box 731582 San Jose CA 95173-1582 |
| Practice Telephone | 4085319961 |
| Practice Fax Number | 8558317973 |
| Mailing Telephone | 4085319961 |
| Mailing Fax Number | 8558317973 |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | KEVIN DANG (PRESIDENT,PIC, AO) |
| Authorized Official Telephone | 4083910700 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY51198 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2158376 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033740691 | Evergreen Pharmacy Inc | Pharmacy | 4110 S Maryland Pkwy Ste 17, Las Vegas, NV 89119-7505 | 2020-01-31 |
| 1740549500 | Evergreen Pharmacy Inc | Pharmacy | 875 E 10th Ave, Hialeah, FL 33010-4645 | 2012-05-14 |
| 1396933545 | Evergreen Pharmacy Inc | Pharmacy | 2690 S White Rd, Ste 200a, San Jose, CA 95148-2076 | 2007-10-11 |
| 1720199888 | Evergreen Pharmacy Inc | Pharmacy | 20010 W Warren Ave, Detroit, MI 48228-3250 | 2006-08-31 |
| Street Address |
2365 QUIMBY RD STE 150 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95122-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437788015 | Vietnam Pharmacy Inc | Pharmacy | 2451 S King Rd Suite A1, San Jose, CA 95122 | 2020-04-06 |
| 1346894524 | Amy Le Tran | Counselor | Mekong Community Center, 2203 Tully Road, San Jose, CA 95122 | 2019-07-26 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1740761196 | Aileen Phu | Acupuncturist | 1271 Story Rd Ste 50, San Jose, CA 95122 | 2018-08-23 |
| 1740775816 | Urgent Care Clinic of Northern Ca Inc | Clinic/Center | 999 Story Road, Suite 9021, San Jose, CA 95122 | 2018-06-29 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1497113153 | Jamealle Spain | Case Manager/Care Coordinator | 2070 Lucretia Ave #310, San Jose, CA 95122 | 2016-02-09 |
| 1770915035 | Thinh Tran | Dentist | 919 Story Rd Unit 1128, San Jose, CA 95122 | 2013-08-08 |
| 1356591333 | Asian American Recovery Services | Counselor | 1340 Tully Rd., San Jose, CA 95122 | 2008-09-25 |
| 1821246505 | Samara Rachel Stone | Marriage & Family Therapist | 1340 Tully Road, Suite 304, San Jose, CA 95122 | 2008-09-05 |
| Find all providers in zip 95122 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
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| 1285259473 | Advance Sj Pharmacy, Inc | Pharmacy | 2331a Montpelier Dr Ste A-10, San Jose, CA 95116-1614 | 2020-06-12 |
| 1902388697 | Downtown Pharmacy Inc | Pharmacy | 60 N 13th St Ste A, San Jose, CA 95112-3525 | 2018-08-30 |
| 1811490659 | Tiffany Thu, Inc. | Pharmacy | 2323 Montpelier Dr Ste D, San Jose, CA 95116-1611 | 2018-03-16 |
| 1346769395 | S4 Pharmacy Inc | Pharmacy | 3130 Alum Rock Ave, San Jose, CA 95127-2901 | 2017-09-11 |
| 1780062547 | Lion Pharmacy Inc | Pharmacy | 2857 Senter Rd Ste A, San Jose, CA 95111-1100 | 2015-05-13 |
| 1205268984 | Icare Pharmacy | Pharmacy | 1727 Berryessa Rd Ste B, San Jose, CA 95133-1172 | 2013-08-05 |
| 1952532194 | Regional Pharmacy Inc. | Pharmacy | 200 Jose Figueres Ave Ste 235, San Jose, CA 95116-1599 | 2009-08-06 |
| 1427221944 | Friendly Pharmacy Incorporated | Pharmacy | 639 Tully Rd Ste A, San Jose, CA 95111-1000 | 2008-04-04 |
| 1265629802 | Farmacia Remedios Inc | Pharmacy | 996 S King Rd, San Jose, CA 95116-3506 | 2007-09-27 |
| Find all providers in SAN JOSE | ||||
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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.