Organization
WEAVERVILLE PHARMACY INC
Active
Other names
Weaverville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TONY IBRAHIM (CEO)
(760) 987-6796
Entity
Organization
Contact information
Practice address
60 S MINER ST, STE C, WEAVERVILLE, CA 96093
(530) 423-8810
(530) 423-8811
Mailing address
PO BOX 1676, WEAVERVILLE, CA 96093-1676
(530) 423-8810
(530) 423-8811
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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