Organization
EVANS PHARMACY LLC
Active
Other names
Evans Express Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LYNN NUNLEY (OFFICE MANAGER)
(580) 234-4343
Entity
Organization
Contact information
Practice address
110 N OAKWOOD RD, ENID, OK 73703-4946
(580) 233-1202
(580) 233-1208
Mailing address
110 N OAKWOOD RD, ENID, OK 73703-4946
(580) 234-4343
(580) 233-1208
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5-7137
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247450D
—
OK
01
—
2116853
PK
—
Enumeration date
09/08/2008
Last updated
08/22/2019
Update your record
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