Healthcare Provider Details

I. General information

NPI: 1114071297
Provider Name (Legal Business Name): PARKLANE PHARMACY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 S OLIVER STE 141
WICHITA KS
67218-3240
US

IV. Provider business mailing address

1530 S OLIVER STE 141
WICHITA KS
67218-3240
US

V. Phone/Fax

Practice location:
  • Phone: 316-685-2269
  • Fax: 316-685-2621
Mailing address:
  • Phone: 316-685-2269
  • Fax: 316-685-2621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7407
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7407
License Number StateKS

VIII. Authorized Official

Name: MR. VIRGIL R STINSON
Title or Position: PRESIDENT
Credential: REGISTERD PHARMACIST
Phone: 316-685-2269