Organization
KB EVANS DRUG INC
Active
Other names
EVANS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MCCULLOUGH RPH (CHIEF PHARMACIST/OWNER)
(417) 876-3313
Entity
Organization
Contact information
Practice address
209 E US HIGHWAY 54, EL DORADO SPRINGS, MO 64744-1925
(417) 876-3313
(417) 876-3813
Mailing address
209 E US HIGHWAY 54, EL DORADO SPRINGS, MO 64744-1925
(417) 876-3313
(417) 876-3813
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2010042680
MO
3336L0003X
Long Term Care Pharmacy
2010042680
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128300
PK
—
05
—
600120505
—
MO
05
—
620120501
—
MO
Enumeration date
08/21/2006
Last updated
04/11/2020
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