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General NPI Number Information
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NPI Number | 1578206645
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Entity Type | Organization
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Legal Business Name | EP EVANS DRUG, INC
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 107 S OAK ST
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City | NEVADA
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State | MO
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Zip | 64772-3436
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Country | US
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Telephone | 417-876-5601
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Fax | 417-876-5604
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Provider Business Mailing Address
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Address Line | 200 E US HIGHWAY 54
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City | EL DORADO SPG
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State | MO
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Zip | 64744-1926
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Country | US
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Telephone | 417-876-5601
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Fax | 417-876-5604
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Authorized Official
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Title or Position | MANAGER
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Name | RENEA HAYES
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Credential |
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Telephone | 417-876-5601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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