Weport Medical Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

WEPORT MEDICAL PHARMACY

Practice address

1220 S Vista Ave Ste a
Boise, ID 83705-2530

Phone

(816) 405-2406

NPI assigned

Mar 4, 2026

Organization subpart

No

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

Authorized official

Name

Khaled Eldemerdash, RPHNPI 1568206423

Title

Managing Director

Phone

(816) 405-2406

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khaled Eldemerdash, RPH

  • Pharmacist
  • Boise, ID
  • NPI 1568206423
  NPD Authorized official

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1386599371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 S VISTA AVE STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052530",
            "telephone_number": "816-405-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S VISTA AVE STE A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052530",
            "telephone_number": "816-405-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEPORT MEDICAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "ELDEMERDASH",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "816-405-2406",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Wenetzky, LCSW
• Jared Wenn
• Rebecca Wensel, P.T.
• Laura Wensman
• Tom Wenzel
• William Guy Weppner, M.D.
• John M Werdel, MD
• Avonlea Werdell
• Kathryn Ann Werner, PA
• Amy Marie Wernsing, LPC

• Long Term Care Pharmacy in Boise, ID
• Providers in Boise, ID by specialty
• Long Term Care Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.