1. Home
  2. Directory
  3. Wisconsin
  4. West Allis
  5. Pharmacy
  6. NPI Profile

EVERGREEN PHARMACY LLC
NPI 1487101754
Pharmacy in West Allis, WI

Active since September 05, 2016CLIA 52D2129218 · Waiver
10101 W GREENFIELD AVE, WEST ALLIS, WI 53214(414) 533-6600(414) 533-6601 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2023, May 10, 2020, Sep 20, 2016 (3 updates tracked since 2016).

About Evergreen Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN PHARMACY LLC (NPI 1487101754) is a healthcare organization registered as a pharmacy in West Allis, Wisconsin and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through April 28, 2028 and lists Richard A Pearson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1487101754
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameEVERGREEN PHARMACY LLC
Location Address10101 W GREENFIELD AVEWest Allis, WI 53214-3953
Mailing Address10101 W Greenfield AveWest Allis, WI 53214-3953 · (414) 533-6600 · Fax (414) 533-6601
Phone(414) 533-6600
Fax(414) 533-6601
Organization SubpartNo
Authorized OfficialRichard A PearsonCeo · (414) 727-5750
Enumeration DateSeptember 5, 2016
Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration
NPPES CertifiedMay 10, 2020
✔ NPI 1487101754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in WI · 9421-42
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.
Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
10101 W GREENFIELD AVE, West Allis, WI 53214
Open in Google Maps ↗

Other Identifiers 1

Other9421-42WI · State Pharmacy License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2129218

Evergreen Pharmacy · West Allis, WI
Active · expires Apr 28, 2028
CLIA Number52D2129218
Laboratory TypePharmacy
Certificate Effective DateApril 29, 2026
Certificate Expiration DateApril 28, 2028
Laboratory DirectorBenjamin Pearson
Laboratory Phone(414) 533-6600
Laboratory LocationEvergreen Pharmacy10101 W Greenfield Ave, Suite 130, West Allis, WI 53214
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Pharmacy LLC's NPI number?

The NPI number for Evergreen Pharmacy LLC is 1487101754. It was assigned to this organization in the NPPES registry on September 5, 2016.

Where is Evergreen Pharmacy LLC located?

Evergreen Pharmacy LLC is located at 10101 W Greenfield Ave, West Allis, WI 53214. The listed phone number is (414) 533-6600.

What is Evergreen Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Evergreen Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2129218) is associated with this NPI, valid through April 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Evergreen Pharmacy LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and Baylor Scott and White Health Plan and 26 other insurers list Evergreen Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Evergreen Pharmacy LLC was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.