Organization
EVANS DRUGS SUNRISE BEACH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY TIMMERMANN (MANAGER)
(417) 876-3313
Entity
Organization
Contact information
Practice address
13655 N STATE HIGHWAY 5, SUNRISE BEACH, MO 65079-7449
(573) 372-8305
(573) 372-8308
Mailing address
209 E US HIGHWAY 54, EL DORADO SPRINGS, MO 64744-1925
(417) 876-3313
(417) 876-2326
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2013013674
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
05/16/2013
Last updated
10/05/2021
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