Evans Total Care, LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Fulton, KY
NPI 1477583326 · NPPES record last updated Nov 20, 2011
Key facts
- NPI
- 1477583326
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- MG0530 (KY)
- Legal business name
- EVANS TOTAL CARE, LLC
- Practice address
- 208 Lake St
Fulton, KY 42041-1544 - Phone
- (270) 472-2984
- Fax
- (270) 472-9377
- NPI assigned
- Jul 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. David Stewart Prater Jr., PHARM D.
- Title
- Owner
- Phone
- (270) 472-2984
Practitioners 1
-
David Stewart Prater Jr., PHARM D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Evans Total Care LLC |
Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Hospital Beds (Electric)|Pneumatic Compression Devices and/or Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Traction Equipment|Canes and/or Crutches|Patient Lifts|Power Operated Vehicles (Scooters)|Seat Lift M… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930095299 | KY | DME Supplier - Medical Supply Company |
7315152956 | Practice locations: Fulton, KY |
National Provider Directory
Locations
208 Lake St
Fulton, KY 42041
Phone (270) 472-2984
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | MG0530 | KY | Yes |
| Pharmacy | 333600000X | MG0530 | KY |
Addresses
Primary practice location
208 Lake St
Fulton, KY 42041-1544
Mailing address
208 Lake St
Fulton, KY 42041-1544
Phone (270) 472-2984
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000298324 | Other | KY | ANTHEM BCBS |
| 1454274 | Medicaid | TN | |
| 90005596 | Medicaid | KY | |
| 4067258 | Other | TN | BCBS TN |
Other providers in Fulton, KY
- Elizabeth Jane Campbell
- Changes Rehabilitation LLC
- Changes Rehabilitation LLC.
- Diversicare of Fulton, LLC
- Evans Drug Company PLLC
- Fulton City School Clinic
- Fulton County Transit Authority
- Fulton Emergency Services II, LLC
- Fulton Investors, LLC
- Fulton Nursing and Rehabilitation LLC
All providers in Fulton, KY · Durable Medical Equipment & Medical Supplies in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.