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NPI Code Detail

MEDICARE: EVAN'S DRUG

MEDICARE: EVAN'S DRUG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies06889KS

General Provider Information

NPI Number : 1790997096
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVAN'S DRUG
Provider Business Mailing Address
First Line : 116 W PINE ST
Second Line : PO BOX 309
City : COLUMBUS
State : KS
Zip : 66725-1705
Country : US
Telephone Number : 620-429-3322
Fax Number : 620-429-1322
Provider Business Practice Location Address
First Line : 116 W PINE ST
Second Line :
City : COLUMBUS
State : KS
Zip : 66725-1705
Country : US
Telephone Number : 620-429-3322
Fax Number : 620-429-1322
Authorized Official
Title or Position : OWNER
Name : JASON WADE HULVEY
Credential : PHARMD
Telephone Number : 620-429-3322
Provider Enumeration Date : 05/07/2007
Last Update Date : 08/22/2020

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Directions to “EVAN'S DRUG ” Practice Location

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