Organization
EVERGREEN PHARMACEUTICAL LLC
Active
Other names
Omnicare of Portland #48329
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
11933 NE GLENN WIDING DR, PORTLAND, OR 97220-9099
(503) 254-1647
(503) 262-8763
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
07/17/2024
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