Organization
EHS, INC.
Active
Other names
The Pharmacy at Evergreen
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ANNE STACK (AVP OF REVENUE CYCLE MGMT)
(716) 880-7399
Entity
Organization
Contact information
Practice address
206 SOUTH ELMWOOD AVE, BUFFALO, NY 14201
(716) 541-0656
(716) 541-0661
Mailing address
206 SOUTH ELMWOOD AVE, BUFFALO, NY 14201
(716) 541-0656
(716) 541-0661
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
030723
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03370596
—
NY
01
—
2131014
PK
—
Enumeration date
07/11/2011
Last updated
11/29/2022
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