Evans Drug Company PLLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

EVANS DRUG COMPANY PLLC

Practice address

214 Lake Street
Fulton, KY 42041

Phone

(270) 472-2421

Fax

(270) 472-0103

NPI assigned

Oct 2, 2006

Last updated

Dec 20, 2024By 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

Dr. David S Prater Jr., PHARM D.NPI 1689662108

Title

Owner/Pharmacist

Phone

(270) 472-2421

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY2 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 1

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.

• David Stewart Prater Jr., PHARM D.

  • Pharmacist
  • Fulton, KY
  • NPI 1689662108
  NPD Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1356434930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 LAKE STREET",
            "city": "FULTON",
            "state": "KY",
            "postal_code": "42041",
            "telephone_number": "270-472-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 LAKE STREET",
            "city": "FULTON",
            "state": "KY",
            "postal_code": "42041",
            "telephone_number": "270-472-2421",
            "fax_number": "270-472-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS DRUG COMPANY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "270-472-2421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "10684",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54035050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Burditt
• Elizabeth Jane Campbell, PHARMD
• Changes Rehabilitation LLC
• Changes Rehabilitation LLC.
• Diversicare of Fulton, LLC (Diversicare of Fulton)
• Evans Total Care, LLC
• Fulton City School Clinic
• Fulton County Transit Authority
• Fulton Emergency Services II, LLC
• Fulton Investors, LLC (Haws Memorial Nursing & Rehabilitatin Center)

• Community/Retail Pharmacy in Fulton, KY
• Providers in Fulton, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.