# EVERGREEN PHARMACEUTICAL OF CALIFORNIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Omnicare of Cerritos, Omnicare of Cerritos \#48211
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679685994
- **Authorized official:** SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS)
- **Authorized official phone:** (401) 770-2751

## Contact information

- **Practice address:** 13825 CERRITOS CORPORATE DR, SUITE A 1 & A2, CERRITOS, CA 90703-2471
- **Practice address phone:** (562) 229-3500
- **Practice address fax:** (562) 229-3595
- **Mailing address:** 1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
- **Mailing address phone:** (401) 765-1500

## Taxonomy

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

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 01/04/2021