| NPI | 1083067995 |
|---|---|
| Doing Business As | EVERGREEN SHOP PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MANAL KEST Corparation Officer 310-866-3415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 54456) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-08-10 |