EVERGREEN HEALTH SERVICES LLC NPI 1578704466

NPI Information

  • NPI: 1578704466
  • Provider Name: EVERGREEN HEALTH SERVICES, LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 4276 LEGEND AVE
    FAYETTEVILLE, NC
    ZIP 28303
  • Phone: (910) 867-0035

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NPI Details

EVERGREEN HEALTH SERVICES, LLC is a clinic center in Fayetteville, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). EVERGREEN HEALTH SERVICES, LLC NPI is 1578704466. The provider is registered as an organization entity type.

The provider's business location address is:

4276 LEGEND AVE
FAYETTEVILLE, NC
ZIP 28303-965
Phone: (910) 867-0035
Fax: (910) 867-0545

The provider's authorized official is Brenton Blake Byrd .
The authorized official title is Ceo and has the following contact phone number (910) 640-5512.

The enumeration date for this NPI number is 3/23/2009 and was last updated on 3/23/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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