The Pharmacy Shop of Weimar Inc
Organization Active NPI Community/Retail Pharmacy · Weimar, TX
NPI 1922546753 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1922546753
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 31342 (TX)
- Legal business name
- THE PHARMACY SHOP OF WEIMAR INC
- Practice address
- 406 Youens Dr
Weimar, TX 78962-3680 - Phone
- (979) 725-6713
- Fax
- (979) 725-6655
- NPI assigned
- Jan 31, 2017
- Organization subpart
- No
Authorized official
- Name
- Judi Henneke
- Title
- Owner/Pic
- Phone
- (979) 725-6713
Corporate family (same tax ID) 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180404000765 | TX | Part B Supplier - Pharmacy | 5496017717 | Practice locations: Weimar, TX |
National Provider Directory
- Tax ID family
- The Pharmacy Shop
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 31342 | TX | Yes |
Addresses
Primary practice location
406 Youens Dr
Weimar, TX 78962-3680
Mailing address
406 Youens Dr
Weimar, TX 78962
Phone (979) 725-6713
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2167597 | Other | PK | |
| 149620 | Medicaid | TX |
Other names
- The Pharmacy Shop
Other providers in Weimar, TX
- Brandie Montgomery
- Estela Mota
- Phoenix Dialysis LLC
- Sochanet,Inc
- The Pharmacy Shop of Weimar Inc
- Curtis Martin Van Houten
- Charles Bancroft Vretis
- Pattie Stephens Vretis
- Weimar Assisted Living Partners, Inc.
- Weimar II Enterprises, LLC
All providers in Weimar, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.