Organization
EVANS DRUGS OF TEKONSHA LLC
Active
Other names
EVANS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
GABE ZAWAIDEH RPH (MANAGER PRESIDENT)
(248) 931-5398
Entity
Organization
Contact information
Practice address
129 N MAIN ST, TEKONSHA, MI 49092-5114
(517) 767-3474
(517) 767-4603
Mailing address
129 N MAIN ST, TEKONSHA, MI 49092-5114
(517) 767-3474
(517) 767-4603
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008507
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1696265
—
MI
01
—
2339388
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/05/2006
Last updated
04/12/2010
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