Evergreen Pharmacy & Supplies LLC
Organization Active NPI Pharmacy · Maite, GU
NPI 1972076792 · NPPES record last updated Jan 3, 2019
Key facts
- NPI
- 1972076792
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- EVERGREEN PHARMACY & SUPPLIES LLC
- Practice address
- 520 Route 8
Maite, GU 96910 - Phone
- (671) 477-5091
- NPI assigned
- Jan 3, 2019
- Organization subpart
- No
Authorized official
- Name
- Gary Roy, RPH
- Title
- Pharmacy Manager
- Phone
- (671) 687-9175
Practitioners 1
-
Gary Roy, RPH
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
520 Route 8
Maite, GU 96910
Mailing address
520 Route 8
Maite, GU 96910
Other providers in Maite, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.