Evergreen Pharmacy, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

28RS00761800 Issued in NJ

Legal business name

EVERGREEN PHARMACY, INC

Doing business as

Evergreen Pharmacy

Practice address

7 Broad Ave Ste 105
Palisades Park, NJ 07650-1886

Phone

(201) 941-1111

Fax

(201) 941-1124

NPI assigned

Jan 12, 2018

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yongsun Cho

Title

Manager

Phone

(201) 941-1111

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Evergreen Pharmacy Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Youjin Hwang

  • Pharmacist
  • Fort Lee, NJ
  • NPI 1952811671
  NPD (past)
• Hayoung Kim

  • Pharmacist
  • Palisades Park, NJ
  • NPI 1467912188
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1083122949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BROAD AVE STE 105",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501886",
            "telephone_number": "201-941-1111",
            "fax_number": "201-941-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BROAD AVE STE 105",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501886",
            "telephone_number": "201-941-1111",
            "fax_number": "201-941-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "YONGSUN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-941-1111"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00761800",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0619353",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176951",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Coast Orthotic & Prosthetic Corp..
• Elderly Care Solutions LLC
• Elite Physical Medicine LLC
• Elizabeth Eo
• Soo Eo
• Luke Edmund Eyerman, M.D.
• Family Eye Clinic, Inc.
• George Xenakis, DDS, Palisades Park, LLC
• Golden Cares Pharmacy Inc
• Vanessa Gonzalez, PHARM D

• Pharmacy in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.