<Unavail>

LBN: Evergreen Rx Inc
<Unavail> is an health care organization with primary practice located at 11779 Santa Monica Blvd , Los Angeles CA 90025-2843. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Evergreen Rx Inc can be contacted via phone (310) 444-9011, or through Akopyan, Yury via phone (310) 444-9011.

Contact Information

Primary practice address
11779 Santa Monica Blvd Los Angeles CA 90025-2843
Phone: (310) 444-9011
Fax: (310) 444-0418
Website:
Map and Directions
Authorized official contact:
Name: Akopyan, Yury
Phone: (310) 444-9011

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY51906 California
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1346241700
LBN Legal business name Evergreen Rx Inc
DBA Doing business as <Unavail>
Authorized official Akopyan, Yury
Entity Organization
Organization subpart 1 No
Enumeration date Aug 9th, 2005
Last updated Dec 3rd, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346241700 NPPES
California MEDICAID 1346241700
California Other 2151974

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