Individual provider Active NPI

Benton Wolke, PHARMD

  • Pharmacist
  • Muncie, IN
National Provider Identifier
1689309882
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26029799A Issued in IN
Practice address
6260 W McGalliard Rd
Muncie, IN 47304-9413
Phone
(765) 281-7810
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26029799A IN Primary

Addresses

Primary practice location

6260 W McGalliard Rd
Muncie, IN 47304-9413

Mailing address

6260 W McGalliard Rd
Muncie, IN 47304-9413
Phone (765) 281-7810

Other identifiers 1

IdentifierTypeStateIssuer
26029799AOtherININDIANA BOARD OF PHARMACY

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26029799AINMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689309882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473049413",
            "telephone_number": "765-281-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473049413",
            "telephone_number": "765-281-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLKE",
        "first_name": "BENTON",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26029799A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA BOARD OF PHARMACY",
            "identifier": "26029799A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.