NPIMap

Organization Active NPI

Evans Pharmacy LLC

Doing business as Evans Pharmacy Viatl Care

  • Home Infusion Therapy Pharmacy
  • Enid, OK
National Provider Identifier
1003835067
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
5-4603 Issued in OK
Legal business name
EVANS PHARMACY LLC
Doing business as
Evans Pharmacy Viatl Care
Practice address
1106 W Willow Rd
Enid, OK 73703-2503
Phone
(508) 234-4343
Fax
(580) 234-5477
NPI assigned
Jul 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kyle Whitehead
Title
Partner
Phone
(580) 234-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Therapy Pharmacy 3336H0001X 5-4603 OK Primary

Addresses

Primary practice location

1106 W Willow Rd
Enid, OK 73703-2503

Mailing address

PO Box 5047
Meridian, MS 39302-5047
Phone (800) 447-4095

Other identifiers 4

IdentifierTypeStateIssuer
100247450AMedicaidOK
37143288001OtherOKBCBS HIT
100232660EMedicaidOK
100247450COtherOKOK HEALTHCARE AUTHORITY

Other names 1

  • Evans Pharmacy Viatl Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evans Pharmacy LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003835067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5047",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025047",
            "telephone_number": "800-447-4095",
            "fax_number": "601-482-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 W WILLOW RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032503",
            "telephone_number": "508-234-4343",
            "fax_number": "580-234-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "580-234-4343"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "OK",
            "license": "5-4603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247450A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HIT",
            "identifier": "37143288001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100232660E",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK HEALTHCARE AUTHORITY",
            "identifier": "100247450C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evans Pharmacy Viatl Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.