KB Evans Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2010042680 Issued in MO

Legal business name

KB EVANS DRUG INC

Doing business as

Evans Drugs

Practice address

209 E US Highway 54
El Dorado Springs, MO 64744-1925

Phone

(417) 876-3313

Fax

(417) 876-3813

NPI assigned

Aug 21, 2006

Last updated

Apr 11, 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 McCullough, RPHNPI 1679609721

Title

Chief Pharmacist/Owner

Phone

(417) 876-3313

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• EVANS DRUGS Doing business as

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

Tax ID family

KB Evans Drug Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• KB Evans Drug Inc

  dba Evans Drugs

  • Long Term Care Pharmacy
  • El Dorado Springs, MO
  • NPI 1619513827
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Ep Evans Drug, Inc

  dba Physicians Medical Equipment and Supplies

  • Durable Medical Equipment & Medical Supplies
  • Nevada, MO
  • NPI 1578206645

  Member Of

  NPD member

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.

• Kevin Alan McCullough, PHARM.D.

  • Pharmacist
  • El Dorado Springs, MO
  • NPI 1679609721
  Authorized official Same address or phone

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586563200000",
    "number": "1578679056",
    "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": "417-876-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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": "417-876-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB EVANS DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-04-11",
        "certification_date": "2020-04-11",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF PHARMACIST/OWNER",
        "authorized_official_telephone_number": "417-876-3313",
        "authorized_official_credential": "RPH"
    },
    "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": "2010042680",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MO",
            "license": "2010042680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620120501",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600120505",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVANS DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• I Am Health Clinic, LLC
• Michelle Rene' Jackson, MSW, LCSW
• Amber Johnson, PA
• Melissa B Jones, DO
• Rachel Kauffman, PHARMD
• KB Evans Drug Inc (Evans Drugs)
• Jessica Marie La Falce, LCSW
• Neil Lloyd Linsenmayer, DC
• Nancy A Maenhoudt, LCSW
• Cory Martin

• Community/Retail Pharmacy in El Dorado Springs, MO
• Providers in El Dorado Springs, 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 Apr 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.