Evergreen Shop Pharmacy INC
NPI #1083067995 in Glendora, California
Provider Information
- NPI Number
- 1083067995
- Entity Type
- Organization
- Organization Name
- Evergreen Shop Pharmacy INC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jul 14, 2016
- Last Updated
- Aug 10, 2016
Practice Location
- Address
- 150 S GRAND AVE STE K
- City
- Glendora
- State
- California
- ZIP Code
- 91741-4715
- Phone
- (626) 335-2442
Authorized Official
- Name
- MANAL KEST
- Title
- CORPARATION OFFICER
- Phone
- (310) 866-3415
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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