Evergreen Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

EVERGREEN PHARMACY

Practice address

118 E Red Bank Ave
Woodbury, NJ 08096-3559

Phone

(856) 848-6446

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven Isaacson

Title

Pharmacist

Phone

(856) 848-6446

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1215092671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E RED BANK AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080963559",
            "telephone_number": "856-848-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E RED BANK AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080963559",
            "telephone_number": "856-848-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "ISAACSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "856-848-6446",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4244303",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.