Yreka Pharmacy, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

YREKA PHARMACY, INC.

Practice address

748 S Main St
Yreka, CA 96097-3319

Phone

(530) 698-0990

Fax

(530) 698-0991

NPI assigned

Oct 4, 2023

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other names 1

• Yreka Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1730969882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973319",
            "telephone_number": "530-698-0990",
            "fax_number": "530-698-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973319",
            "telephone_number": "530-698-0990",
            "fax_number": "530-698-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YREKA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "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": "Yreka Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Moudy Samir Youssef, M.D.
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• Yreka Chiropractic Dr J C Morris Inc
• Yreka Pharmacy Inc
• Yreka Union Elementary School District
• Yreka Union High School District
• Yreka Womens Clinic a Medical Corporation
• Stephanie Zack, LCSW
• Elizabeth Zandona, LVN

• Long Term Care Pharmacy in Yreka, CA
• Providers in Yreka, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.