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General NPI Number Information
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NPI Number | 1386599371
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Entity Type | Organization
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Legal Business Name | WEPORT HEALTHCARE SOLUTIONS
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 1220 S VISTA AVE STE A
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City | BOISE
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State | ID
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Zip | 83705-2530
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Country | US
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Telephone | 816-405-2406
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 S VISTA AVE STE A
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City | BOISE
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State | ID
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Zip | 83705-2530
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Country | US
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Telephone | 816-405-2406
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | KHALED ELDEMERDASH
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Credential | RPH
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Telephone | 816-405-2406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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