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WOODY WEAVER PHARMACY NPI 1629136460


NPI Information

NPI: 1629136460
Provider Name: WOODY WEAVER PHARMACY
Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
2722 WEST GENTRY PARKWAY
TYLER, TX
ZIP 75702
Phone: (903) 593-2533
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WOODY WEAVER PHARMACY is a pharmacy in Tyler, TX. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. WOODY WEAVER PHARMACY NPI is 1629136460. The provider is registered as an organization entity type.

The provider's business location address is:

2722 WEST GENTRY PARKWAY
TYLER, TX
ZIP 75702
Phone: (903) 593-2533
Fax: (903) 593-2555

The provider's authorized official is Woodrow Vernon Weaver .
The authorized official title is Owner and has the following contact phone number (903) 593-2533.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1130525MEDICAIDTEXAS
24532936OTHERNABP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.