# EAST ORANGE PHARMACY EVERGREEEN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386270742
- **Authorized official:** MR. TIM CHIU (PHARMACIST/OWNER)
- **Authorized official phone:** (862) 444-7188

## Contact information

- **Practice address:** 60 EVERGREEN PL STE 104, EAST ORANGE, NJ 07018-2114
- **Practice address phone:** (862) 444-7188
- **Practice address fax:** (862) 444-7183
- **Mailing address:** 60 EVERGREEN PL STE 104, EAST ORANGE, NJ 07018-2114
- **Mailing address phone:** (862) 444-7188
- **Mailing address fax:** (862) 444-7183

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/18/2020
- **Last updated:** 03/18/2020