Active NPI
Weaverville Pharmacy Inc
Doing business as Weaverville Pharmacy
- Long Term Care Pharmacy
- Weaverville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- WEAVERVILLE PHARMACY INC
- Doing business as
- Weaverville Pharmacy
- Practice address
- 60 S Miner St
Ste C
Weaverville, CA 96093 - Phone
- (530) 423-8810
- Fax
- (530) 423-8811
- NPI assigned
- Oct 6, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony Ibrahim
- Title
- Ceo
- Phone
- (760) 987-6796
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
60 S Miner St
Ste C
Weaverville, CA 96093
Mailing address
PO Box 1676
Weaverville, CA 96093-1676
Phone (530) 423-8810
Other names 1
- Weaverville Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Apple Specialty Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Victorville, CA
- NPI 1336453117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696550400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696550400000",
"number": "1427839422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1676",
"city": "WEAVERVILLE",
"state": "CA",
"postal_code": "960931676",
"telephone_number": "530-423-8810",
"fax_number": "530-423-8811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 S MINER ST",
"address_2": "STE C",
"city": "WEAVERVILLE",
"state": "CA",
"postal_code": "96093",
"telephone_number": "530-423-8810",
"fax_number": "530-423-8811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEAVERVILLE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-06",
"last_updated": "2023-10-06",
"certification_date": "2023-10-05",
"status": "A",
"authorized_official_last_name": "IBRAHIM",
"authorized_official_first_name": "TONY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "760-987-6796"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Weaverville Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Weaverville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.