Provider Demographics
NPI:1790997096
Name:EVAN'S DRUG
Entity Type:Organization
Organization Name:EVAN'S DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:HULVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:620-429-3322
Mailing Address - Street 1:116 W PINE ST
Mailing Address - Street 2:PO BOX 309
Mailing Address - City:COLUMBUS
Mailing Address - State:KS
Mailing Address - Zip Code:66725-1705
Mailing Address - Country:US
Mailing Address - Phone:620-429-3322
Mailing Address - Fax:620-429-1322
Practice Address - Street 1:116 W PINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-1705
Practice Address - Country:US
Practice Address - Phone:620-429-3322
Practice Address - Fax:620-429-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS06889332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies