Organization
EVANS DRUGS OF SAINT LOUIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WAYNE BROOKS RPH (OWNER)
(989) 463-3356
Entity
Organization
Contact information
Practice address
116 N MILL ST, SAINT LOUIS, MI 48880-1521
(989) 681-6633
(989) 681-6644
Mailing address
116 N MILL ST, SAINT LOUIS, MI 48880-1521
(989) 681-6633
(989) 681-6644
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5301006843
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B90273
BLUE CROSS DME
MI
05
—
3504815
—
MI
Enumeration date
07/27/2005
Last updated
08/22/2020
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