Evergreen Health RX LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

EVERGREEN HEALTH RX LLC

Practice address

165 Ferry St
Newark, NJ 07105-2179

Phone

(973) 344-0394

NPI assigned

Jan 9, 2025

Organization subpart

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ferry Pharmacy Doing business as

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"
        }
    ]
}

• Michelle Evans-Pontrelli, MD
• Benjamin Marvin Evans, RN APN-C
• Nicholas Michael Evans, MD
• Shae Evans
• Tanita Evans
• Heather B. Evers, CPNP
• Joan Everson, APN
• Everyday Services and Transportation LLC
• Evidence Transportation and Logistics
• Evolve Therapy LLC

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

• 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.

Verify at the official NPI Registry.