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General NPI Number Information
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NPI Number | 1972506582
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Entity Type | Organization
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Legal Business Name | WEYRAUCH'S PHARMACY, LLC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 05/11/2024
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Provider Practice Location Address
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Address Line | 4959 KIDRON RD
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City | KIDRON
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State | OH
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Zip | 44636-0231
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Country | US
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Telephone | 330-857-0115
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Fax | 330-857-1731
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Provider Business Mailing Address
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Address Line | 4959 KIDRON RD PO BOX 231
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City | KIDRON
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State | OH
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Zip | 44636-0231
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Country | US
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Telephone | 330-857-0115
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Fax | 330-857-1731
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOHN A WEYRAUCH
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Credential | RPH
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Telephone | 330-857-0115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 02-0585000
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License Number State | OH
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