Evans Drugs of Saint Louis LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5301006843 Issued in MI

Legal business name

EVANS DRUGS OF SAINT LOUIS LLC

Practice address

116 N Mill St
Saint Louis, MI 48880-1521

Phone

(989) 681-6633

Fax

(989) 681-6644

NPI assigned

Jul 27, 2005

Last updated

Aug 22, 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

Charles Wayne Brooks, RPH

Title

Owner

Phone

(989) 463-3356

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386644839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N MILL ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801521",
            "telephone_number": "989-681-6633",
            "fax_number": "989-681-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N MILL ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801521",
            "telephone_number": "989-681-6633",
            "fax_number": "989-681-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS DRUGS OF SAINT LOUIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-463-3356",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301006843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DME",
            "identifier": "0B90273",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3504815",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Justin Michael Elliott, OTRL
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• Joseph Gelina, PA
• Jennifer Marie Gushen, RN
• Sarah Haesler, DC

• Durable Medical Equipment & Medical Supplies in Saint Louis, MI
• Providers in Saint Louis, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• 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.