Active NPI
Enyioha Ennis Egorugwu, RPH
- Pharmacist
- Salina, KS
National Provider Identifier
1336416817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-12060
- Practice address
- 700 S Broadway Blvd
Salina, KS 67401-4655 - Phone
- (785) 827-3974
- Fax
- (785) 826-9688
- NPI assigned
- Nov 28, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-12060 | KS | Primary |
| Pharmacist | 183500000X | 040267 | MO |
Addresses
Primary practice location
700 S Broadway Blvd
Salina, KS 67401-4655
Mailing address
6206 N Cypress Ave
Kansas City, MO 64119-5051
Phone (816) 453-9114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-12060 | KS | MD | Pharmacist |
| 040267 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1336416817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6206 N CYPRESS AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641195051",
"telephone_number": "816-453-9114",
"fax_number": "816-453-9114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S BROADWAY BLVD",
"city": "SALINA",
"state": "KS",
"postal_code": "674014655",
"telephone_number": "785-827-3974",
"fax_number": "785-826-9688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGORUGWU",
"first_name": "ENYIOHA",
"middle_name": "ENNIS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-28",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-12060",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "040267",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salina, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.