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Export Provider Record NPI 1104919547
Evetts Drug Inc.
Organization Subpart: NO
Active
NPI Number1104919547
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1104919547
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-09-30
Last Updated2015-11-18
Authorized OfficialJimmy Evetts
OWNER
Phone: 5808323388
Mailing Address100 E 1st St
Cordell, OK 73632-4810
United States
Phone: (580) 832-3388 | Fax: (580) 832-5271
📍 View Map
Primary Practice Address100 E 1st St
Cordell, OK 73632-4810
United States
Phone: (580) 832-3388 | Fax: (580) 832-5271
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDOK100235580A-
Other (non-Medicare)-2072712PK
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No3336L0003X – Pharmacy, Long Term Care Pharmacy--
Yes3336C0003X – Pharmacy, Community/Retail PharmacyOK332098
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About NPI 1104919547

Evetts Drug Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1104919547. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Cordell, OK. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-09-30. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104919547?

NPI 1104919547 belongs to Evetts Drug Inc., a Pharmacy, Community/Retail Pharmacy in Cordell, OK. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104919547 active?

The current status of NPI 1104919547 in the NPPES registry is Active. The record was last updated on 2015-11-18.

What specialty is NPI 1104919547?

NPI 1104919547 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104919547?

You can verify NPI 1104919547 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104919547?

The primary practice address on file for NPI 1104919547 is 100 E 1st St, Cordell, OK 73632-4810. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104919547 issued?

NPI 1104919547 was first issued (enumerated) on 2006-09-30. The NPPES record was last updated on 2015-11-18.

Practice Location Map

Evetts Drug Inc. is located at 100 E 1st St, Cordell, OK. Use the map below to find directions or verify the practice location.

📍 100 E 1st St, Cordell, OK 73632-4810  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Evetts Drug Inc.. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1104919547. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy332098OK
Data Verified from CMS NPPES Last synced: 2026-08-10 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162