# WEPORT MEDICAL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386599371
- **Authorized official:** KHALED ELDEMERDASH RPH (MANAGING DIRECTOR)
- **Authorized official phone:** (816) 405-2406

## Contact information

- **Practice address:** 1220 S VISTA AVE STE A, BOISE, ID 83705-2530
- **Practice address phone:** (816) 405-2406
- **Mailing address:** 1220 S VISTA AVE STE A, BOISE, ID 83705-2530
- **Mailing address phone:** (816) 405-2406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/04/2026
- **Last updated:** 03/30/2026