Active NPI
Evergreen Health RX LLC
Doing business as Ferry Pharmacy
- Pharmacy
- Newark, NJ
National Provider Identifier
1417767765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- EVERGREEN HEALTH RX LLC
- Doing business as
- Ferry Pharmacy
- Practice address
- 165 Ferry St
Newark, NJ 07105-2179 - Phone
- (973) 344-0394
- NPI assigned
- Jan 9, 2025
- Last updated
- Jan 9, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sherry Bolos
- Title
- Pic
- Phone
- (973) 344-0394
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
165 Ferry St
Newark, NJ 07105-2179
Mailing address
165 Ferry St
Newark, NJ 07105-2179
Phone (973) 344-0394
Other names 1
- Ferry Pharmacy
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Pharmacist
- Newark, NJ
- NPI 1114805322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736380800000",
"number": "1417767765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 FERRY ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071052179",
"telephone_number": "973-344-0394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 FERRY ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071052179",
"telephone_number": "973-344-0394"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN HEALTH RX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-09",
"last_updated": "2025-01-09",
"certification_date": "2025-01-09",
"status": "A",
"authorized_official_last_name": "BOLOS",
"authorized_official_first_name": "SHERRY",
"authorized_official_title_or_position": "PIC",
"authorized_official_telephone_number": "973-344-0394"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ferry Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.