Organization
EVERGREEN PHARMACEUTICAL OF CALIFORNIA, LLC
Active
Other names
Omnicare of Northern California, Omnicare of Northern California #48214
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (SR DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
850 S GUILD AVE, LODI, CA 95240-3170
(209) 333-4900
(209) 333-3601
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
11/01/2006
Last updated
01/04/2021
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