Organization
EVANS PHARMACY LLC
Active
Other names
Evans Pharmacy Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE WHITEHEAD (PARTNER)
(580) 234-4343
Entity
Organization
Contact information
Practice address
1106 W WILLOW RD, ENID, OK 73703-2503
(580) 234-4343
(580) 234-5477
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(580) 234-4343
(580) 234-5477
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
5-4603
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002323660E
—
OK
Enumeration date
07/19/2006
Last updated
08/22/2020
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