Evans Drugs Sunrise Beach LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

EVANS DRUGS SUNRISE BEACH LLC

Practice address

13655 N State Highway 5
Sunrise Beach, MO 65079-7449

Phone

(573) 372-8305

Fax

(573) 372-8308

NPI assigned

May 16, 2013

Organization subpart

No

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

Authorized official

Name

Tracy Timmermann

Title

Manager

Phone

(417) 876-3313

Specialties & licenses 3

Addresses

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

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Butler

  • Pharmacist
  • Sunrise Beach, MO
  • NPI 1053063172
  NPD (past)
• Angela M Neal, BS PHARM

  • Pharmacist
  • Osage Beach, MO
  • NPI 1295029239
  NPD (past)

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1477999555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E US HIGHWAY 54",
            "city": "EL DORADO SPRINGS",
            "state": "MO",
            "postal_code": "647441925",
            "telephone_number": "417-876-3313",
            "fax_number": "417-876-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13655 N STATE HIGHWAY 5",
            "city": "SUNRISE BEACH",
            "state": "MO",
            "postal_code": "650797449",
            "telephone_number": "573-372-8305",
            "fax_number": "573-372-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS DRUGS SUNRISE BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "TIMMERMANN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "417-876-3313"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2013013674",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Allen, L.C.S.W.
• Richard Butler
• Cammo Ambulance District
• Wendy Castle
• Healing Connections Counseling Center, LLC
• Michael P Henry, D.O.
• Carlen Danielle Hite
• Inner Journey Mental Health
• Brandon Keith Johns, D.C.

• Community/Retail Pharmacy in Sunrise Beach, MO
• Providers in Sunrise Beach, 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 Oct 5, 2021; 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.