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NPI Code Detail

MEDICARE: EVERGREEN HEALTH CARE

MEDICARE: EVERGREEN HEALTH CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1770091290
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVERGREEN HEALTH CARE
Provider Business Mailing Address
First Line : 970 SIDNEY MARCUS BLVD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30324-5613
Country : US
Telephone Number : 818-326-3834
Fax Number :
Provider Business Practice Location Address
First Line : 5960 FAIRVIEW RD STE 400
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3119
Country : US
Telephone Number : 206-708-0600
Fax Number : 206-708-0600
Authorized Official
Title or Position : SECRETARY
Name : LUCILLE MCCORMICK
Credential :
Telephone Number : 704-496-2699
Provider Enumeration Date : 01/18/2018
Last Update Date : 01/18/2018

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Directions to “EVERGREEN HEALTH CARE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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