Evans Drugs Lockwood

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

005035 Issued in MO

Legal business name

EVANS DRUGS LOCKWOOD

Doing business as

Lockwood Pharmacy

Practice address

725 Main St
Lockwood, MO 65682-9803

Phone

(417) 232-4721

Fax

(417) 232-5099

NPI assigned

Jul 14, 2006

Last updated

Aug 28, 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 3

Addresses

Other identifiers 2

Other names 2

• LOCKWOOD PHARMACY Doing business as
• Olive Branch Trading Co Former legal business name

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.

Medicare medical equipment & supply locations

Practitioners 2

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
• Lauren Renea Engle, PHARM.D.

  • Pharmacist
  • Lockwood, MO
  • NPI 1639696586
  NPD

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1285650135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 MAIN ST",
            "address_2": "PO BOX R",
            "city": "LOCKWOOD",
            "state": "MO",
            "postal_code": "656829803",
            "telephone_number": "417-232-4721",
            "fax_number": "417-232-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 MAIN ST",
            "city": "LOCKWOOD",
            "state": "MO",
            "postal_code": "656829803",
            "telephone_number": "417-232-4721",
            "fax_number": "417-232-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS DRUGS LOCKWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "005035",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2051138",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600118509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOCKWOOD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Olive Branch Trading Co",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Leisa Dawn Blanchard, FNP-C
• Kelbey Lee Bowles, NP
• Dade County Psychological Services
• Ashley Corine Dawson, NP-C
• Lauren Renea Engle, PHARM.D.
• Good Shepherd Nursing Home
• Travis Tyler Hawks, M.D.
• Beverly A. Holmes, DO
• Jasper R-V School District
• Kayla Lasater

• Community/Retail Pharmacy in Lockwood, MO
• Providers in Lockwood, 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 Aug 28, 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.