GARY ALAN EVANKOVICH, RPH — NPI 1245261452 (Licensed & Credentialed Pharmacist in NORTH LIMA, OH)

CMS-1500 Box 24J / 33a • NPI

1245261452

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

183500000X

Licensed & Credentialed Pharmacist

Box 32 Service Location & ZIP+4

11740 SOUTH AVE, NORTH LIMA, OH, 44452-0301

✓ 9-Digit EDI 837 ZIP+4 (44452-0301)

Practice Phone & Referral Fax

(330) 549-2620

Fax: (330) 549-0042

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1245261452 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(3) — Felony Health Care Fraud Conviction — Effective 2012-03-20). Verify before submitting Medicare/Medicaid claims.

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1245261452` (NPI-1 Individual Practitioner)
Provider / Legal Name	GARY ALAN EVANKOVICH, RPH
Plain-English Specialty	Licensed & Credentialed Pharmacist NUCC Code: `183500000X` (Pharmacist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	11740 SOUTH AVE, NORTH LIMA, OH, 44452-0301
Practice Telephone / Fax	Tel: (330) 549-2620 \| Fax: (330) 549-0042
Administrative Mailing Address	4470 DEVONSHIRE DR, YOUNGSTOWN, OH, 44512-1035
Enumeration & Last Sync	Enumerated: 2006-07-05 \| CMS Record Updated: 2007-07-08

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

11740 SOUTH AVE, NORTH LIMA, OH, 44452-0301

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Plain-English Taxonomy & CMS Crosswalk (183500000X)

What Does Taxonomy Code 183500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 183500000X translates to:
"Licensed & Credentialed Pharmacist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GARY ALAN EVANKOVICH, RPH)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`183500000X` — Pharmacist Plain English: Licensed & Credentialed Pharmacist	State: OH \| License: `03213226` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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GARY ALAN EVANKOVICH, RPH (NPI #1245261452)