MEDICARE: YREKA PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336C0002X	Clinic Pharmacy
2	261QP2300X	Primary Care Clinic/Center
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1528623287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YREKA PHARMACY INC

Provider Business Mailing Address
First Line	:	748 S MAIN ST
Second Line	:
City	:	YREKA
State	:	CA
Zip	:	96097-3319
Country	:	US
Telephone Number	:	530-698-0990
Fax Number	:

Provider Business Practice Location Address
First Line	:	748 S MAIN ST
Second Line	:
City	:	YREKA
State	:	CA
Zip	:	96097-3319
Country	:	US
Telephone Number	:	530-698-0990
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TONY IBRAHIM
Credential	:
Telephone Number	:	530-698-0990

Provider Enumeration Date	:	05/07/2019
Last Update Date	:	05/22/2026

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Directions to “YREKA PHARMACY INC ” Practice Location

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