| NPI | 1447722632 |
|---|---|
| Doing Business As | EVERGREEN PHARMACY II |
| Entity Type | Organization |
| Authorized Contact | KWANG-SIK KIM Owner 267-304-5831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |