BROADWAY PHARMACY PA (NPI# 1144321084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144321084 |
| Entity Type | Organization |
| Organization Name | BROADWAY PHARMACY PA |
| Other Organization Name | BROADWAY PHARMACY |
| Practice Address |
1610 S Broadway St Wichita KS 67211-4119 |
| Practice Telephone | 3162608880 |
| Practice Fax Number | 3162608881 |
| Mailing Telephone | 3162608880 |
| Mailing Fax Number | 3162608881 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-06-25 |
| Authorized Official Name | MR. DAVID B BERGEN (PRESIDENT / PHARMACIST) |
| Authorized Official Telephone | 3162608880 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 209952 | KS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200268670A | 05 | |
| KS | NCPDP | 1718305 | 01 |
| Other Name | Type Code |
|---|---|
| Broadway Pharmacy | Other Name - Individual/Organization |
| Street Address |
1610 S BROADWAY ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67211-4119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386162683 | Karlee Dawn Gluszek | Specialist/Technologist | 1947 S Lulu St, Wichita, KS 67211 | 2017-09-07 |
| 1780139659 | Jaclyn Blyholder | Dentist | 639 S. Hillside, Wichita, KS 67211 | 2016-08-22 |
| 1356715379 | Revitalize Physical Therapy LLC | Physical Therapist | 227 S Ida St, Wichita, KS 67211 | 2015-11-16 |
| 1750753232 | Accurate Sleep Lab | Clinical Medical Laboratory | 411 S Pattie St Suite 2, Wichita, KS 67211 | 2015-10-23 |
| 1841628013 | Joseph Michael Stech | Family Medicine | 940 S. St. Francis, Guadalupe Clinic, Wichita, KS 67211 | 2013-10-24 |
| 1902166648 | Debby Elwood | Counselor | 830 S. Hillside, Wichita, KS 67211 | 2012-05-28 |
| 1205038726 | Patricia (pat) J. Eagleman | Social Worker | 333 S. Greenwood, Wichita, KS 67211 | 2007-06-05 |
| 1114147717 | Rodolfo A Argosino Md Pa | Family Medicine | 1148 S Hillside, 106, Wichita, KS 67211 | 2007-04-26 |
| 1801911086 | Susan Wright Rockley | Physical Therapist | 2535 East Lincoln, Wichita, KS 67211 | 2007-03-20 |
| 1578618021 | Dependable Assisted Living | Home Health | 401 S Greenwood St, Wichita, KS 67211 | 2007-01-24 |
| Find all providers in zip 67211 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861973828 | Dandurand Pharmacy, Inc | Pharmacy | 6227 E 13th St N, Wichita, KS 67208-2654 | 2018-08-27 |
| 1447756457 | Cardinal Health 132 LLC | Pharmacy | 527 N Grove Street, Suite 100, Wichita, KS 67214 | 2018-03-30 |
| 1477062891 | Cardinal Health 132, LLC | Pharmacy | 2707 E 21st St N Ste 201, Wichita, KS 67214-2249 | 2017-09-28 |
| 1962881714 | Senior Care Services Inc | Pharmacy | 555 N Woodlawn St Ste 120, Wichita, KS 67208-3646 | 2015-05-27 |
| 1609001395 | Neighborhood Pharmacy | Pharmacy | 2251 E 21st St N, Suite 121, Wichita, KS 67214-1972 | 2009-05-25 |
| 1730206103 | Jcb Laboratory LLC | Pharmacy | 7335 W 33rd St N, Wichita, KS 67205-9368 | 2007-03-23 |
| 1710002894 | Hac Inc | Pharmacy | 640 N West St, Wichita, KS 67203-1211 | 2007-03-20 |
| 1609991785 | Hac Inc | Pharmacy | 3137 S Seneca St, Wichita, KS 67217-3234 | 2007-03-20 |
| 1801911987 | Hac Inc | Pharmacy | 3020 E Douglas Ave, Wichita, KS 67214-4818 | 2007-03-20 |
| 1518082692 | Hac Inc | Pharmacy | 1607 S Georgetown St, Wichita, KS 67218-4111 | 2007-03-20 |
| Find all providers in WICHITA | ||||
Please comment or provide details below to improve the information on BROADWAY PHARMACY PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.