NPIMap

Organization Active NPI

Evans Specialty Pharmacy

  • Specialty Pharmacy
  • Enid, OK
National Provider Identifier
1982806527
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
5-5173 Issued in OK
Legal business name
EVANS SPECIALTY PHARMACY
Practice address
1110 W Willow Rd
Enid, OK 73703-2503
Phone
(580) 242-1116
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Authorized official

Name
Kyle Keith Whitehead
Title
Owner/Pharmacist
Phone
(580) 234-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X 5-5173 OK Primary

Addresses

Primary practice location

1110 W Willow Rd
Enid, OK 73703-2503

Mailing address

1110 W Willow Rd
Enid, OK 73703-2503

Other identifiers 1

IdentifierTypeStateIssuer
5-5173OtherOKSTATE LICENSE

National Provider Directory

National Provider Directory

Locations

1110 W Willow Rd
Enid, OK 73703
Phone (580) 242-1116

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1982806527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W WILLOW RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W WILLOW RD",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032503",
            "telephone_number": "580-242-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS SPECIALTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "580-234-4343"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "OK",
            "license": "5-5173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5-5173",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.