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Organization

EVANS DRUGS LOCKWOOD

Active
Other names
LOCKWOOD PHARMACY, Olive Branch Trading Co
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN ALAN MCCULLOUGH (OWNER)
(417) 876-3313
Entity
Organization

Contact information

Practice address
725 MAIN ST, LOCKWOOD, MO 65682-9803
(417) 232-4721
(417) 232-5099
Mailing address
725 MAIN ST, PO BOX R, LOCKWOOD, MO 65682-9803
(417) 232-4721
(417) 232-5099

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
005035
MO
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2051138
PK
05
600118509
MO
Enumeration date
07/14/2006
Last updated
08/28/2020
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