Active NPI
Evergreen Equipment Supplies LLC
- Clinical Medical Laboratory
- Woodbridge, VA
National Provider Identifier
1437067030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- EVERGREEN EQUIPMENT SUPPLIES LLC
- Practice address
- 12714 Nettlecreek PL
Woodbridge, VA 22192-8003 - Phone
- (737) 305-6291
- Fax
- (737) 305-8734
- NPI assigned
- Sep 1, 2026
- 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
- Bareera Sadiq
- Title
- Ceo
- Phone
- (737) 305-6291
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
12714 Nettlecreek PL
Woodbridge, VA 22192-8003
Mailing address
12714 Nettlecreek PL
Woodbridge, VA 22192-8003
Phone (737) 305-6291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788652800000",
"number": "1437067030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12714 NETTLECREEK PL",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221928003",
"telephone_number": "737-305-6291",
"fax_number": "737-305-8734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12714 NETTLECREEK PL",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221928003",
"telephone_number": "737-305-6291",
"fax_number": "737-305-8734"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN EQUIPMENT SUPPLIES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-01",
"last_updated": "2026-09-06",
"certification_date": "2026-09-06",
"status": "A",
"authorized_official_last_name": "SADIQ",
"authorized_official_first_name": "BAREERA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "737-305-6291"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.