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Evergreen Pharmacy Llc
Specialty Pharmacy in West Allis, Wisconsin
NPI 1487101754

Evergreen Pharmacy Llc is a Specialty Pharmacy based in West Allis, WI and is specialized in Specialty Pharmacy. Evergreen Pharmacy Llc practices in West Allis, WI. The NPI Number for Evergreen Pharmacy Llc is 1487101754 and holds a License No. 9421-42 (Wisconsin).

The current practice location address for Evergreen Pharmacy Llc is 10101 W Greenfield Ave, West Allis, WI and can be reached out via phone at 414-533-6600 and via fax at 414-533-6601.

Location: 10101 W Greenfield Ave, West Allis, WI, 53214-3953
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1487101754
Provider Name
Evergreen Pharmacy Llc
Credential
Provider Entity Type
Organization
Address
10101 W Greenfield Ave, West Allis, WI, 53214-3953
Phone Number
414-533-6600
Fax Number
414-533-6601
Provider Enumeration Date
09/05/2016
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9421-42 01 WI STATE PHARMACY LICENSE
institution
Provider Business Practice Location Address Details
Address
10101 W Greenfield Ave
City
West Allis
State
Wisconsin
Zip
53214-3953
Phone Number
414-533-6600
Fax Number
414-533-6601
person
Provider Business Mailing Address Details
Address
10101 W Greenfield Ave
City
West Allis
State
Wisconsin
Zip
53214-3953
Phone Number
414-533-6600
Fax Number
414-533-6601
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Long Term Care Pharmacy
Taxonomy
3336L0003X
License No.
()
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Specialty Pharmacy
Taxonomy
3336S0011X
License No.
9421-42 (Wisconsin)
Definition
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.
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