CCN: 497761 NPI: 1235647348 Organization

EVERGREEN HEALTH CARE MANAGEMENT LLC

4115 ANNANDALE ROAD, SUITE 208
ANNANDALE, VA 220032200

Contact Information

Phone 7035345049
Fax 8885883957
Enumeration Date 2018-01-11
Last Updated 2023-04-17

Taxonomies

Code: 163WH0200X
Code: 207Q00000X
Code: 251G00000X
Code: 332B00000X
Code: 342000000X
Code: 343900000X
Code: 344600000X
Code: 347B00000X
Code: 347C00000X
Code: 347E00000X
Code: 251E00000X (Primary) License State: VA License: HCO-1805

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 47894

providerType 36

specialPaymentIndicator

carrierCode 12202

localityCode 01

cbsaActualGeographicLocation 47894

providerType 36

specialPaymentIndicator

carrierCode 12202

localityCode 01

cbsaActualGeographicLocation 47894

providerType 36

specialPaymentIndicator

carrierCode 12202

localityCode 01

EVERGREEN HEALTH CARE MANAGEMENT LLC

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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