Evergreen Pharmacy & Supplies LLC

NPI #1972076792 in Maite, Guam

Provider Information

NPI Number: 1972076792
Entity Type: Organization
Organization Name: Evergreen Pharmacy & Supplies LLC
Primary Specialty: Pharmacy
Enumeration Date: Jan 3, 2019
Last Updated: Jan 3, 2019

Practice Location

Address: 520 ROUTE 8
City: Maite
State: Guam
ZIP Code: 96910
Phone: (671) 477-5091

Authorized Official

Name: GARY ROY, RPH
Title: PHARMACY MANAGER
Phone: (671) 687-9175

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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