Broadway Pharmacy PA

NPI #1144321084 in Wichita, Kansas

Provider Information

NPI Number: 1144321084
Entity Type: Organization
Organization Name: Broadway Pharmacy PA
Primary Specialty: Pharmacy
Enumeration Date: Sep 25, 2006
Last Updated: Jun 25, 2015

Practice Location

Address: 1610 S BROADWAY ST
City: Wichita
State: Kansas
ZIP Code: 67211-4119
Phone: (316) 260-8880

Authorized Official

Name: MR. DAVID B BERGEN, RPH
Title: PRESIDENT / PHARMACIST
Phone: (316) 260-8880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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