Organization
ZUMWALT PHARMACY INC
Active
Other names
EVANS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ALAN MCCULLOUGH (OWNER)
(417) 876-3313
Entity
Organization
Contact information
Practice address
19 PUBLIC SQ, STOCKTON, MO 65785-7617
(417) 276-3128
(417) 276-4914
Mailing address
19 PUBLIC SQ, STOCKTON, MO 65785-7617
(417) 276-3128
(417) 276-4914
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3723
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049877
PK
—
05
—
600900005
—
MO
Enumeration date
09/21/2006
Last updated
04/02/2020
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