Zumwalt Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3723 Issued in MO

Legal business name

ZUMWALT PHARMACY INC

Doing business as

Evans Drugs

Practice address

19 Public SQ
Stockton, MO 65785-7617

Phone

(417) 276-3128

Fax

(417) 276-4914

NPI assigned

Sep 21, 2006

Last updated

Apr 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin Alan McCulloughNPI 1679609721

Title

Owner

Phone

(417) 876-3313

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• EVANS DRUGS Doing business as

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Alan McCullough, PHARM.D.

  • Pharmacist
  • El Dorado Springs, MO
  • NPI 1679609721
  Authorized official Same address or phone
• Jake Gorrell, PHARMD

  • Pharmacist
  • Stockton, MO
  • NPI 1689234528
  NPD (past)
• Debbie Lynn Haines, CPHT

  • Pharmacy Technician
  • Stockton, MO
  • NPI 1891017356
  NPD (past)
• Katherine Marie Hicks, CPHT

  • Pharmacy Technician
  • Stockton, MO
  • NPI 1376865865
  NPD (past)
• Karen Sue Purtle, RPH

  • Pharmacist
  • Stockton, MO
  • NPI 1114249752
  NPD (past)
• Katherine Tenney Henn, PHARMD

  • Pharmacist
  • Kansas City, KS
  • NPI 1699224253
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1124127691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PUBLIC SQ",
            "city": "STOCKTON",
            "state": "MO",
            "postal_code": "657857617",
            "telephone_number": "417-276-3128",
            "fax_number": "417-276-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 PUBLIC SQ",
            "city": "STOCKTON",
            "state": "MO",
            "postal_code": "657857617",
            "telephone_number": "417-276-3128",
            "fax_number": "417-276-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZUMWALT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-876-3313"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "3723",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600900005",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049877",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVANS DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stockton R-I School District
• Thornton Natural Healthcare Centre
• Cheryl Thornton, PSY.D.
• Jeremy Dwain Thornton, D.C.
• Woods Supermarket Inc (Woods Pharmacy 2473)

• Community/Retail Pharmacy in Stockton, MO
• Providers in Stockton, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.