Organization
EVANS PHARMACY LLC
Active
Other names
Evans Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LYNN NUNLEY (OFFICE MANAGER)
(580) 234-4343
Entity
Organization
Contact information
Practice address
1106 W WILLOW RD, ENID, OK 73703-2503
(580) 234-4343
(580) 234-5477
Mailing address
1106 W WILLOW RD, ENID, OK 73703-2503
(580) 234-4343
(580) 234-5477
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5-5107
OK
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
5-5107
OK
333600000X
Pharmacy
5-5107
OK
3336C0003X
Community/Retail Pharmacy
Primary
5-5107
OK
3336L0003X
Long Term Care Pharmacy
5-5107
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247450A
—
OK
Enumeration date
07/11/2006
Last updated
08/19/2021
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