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Export Provider Record NPI 1194506113
Mount Shasta Pharmacy, Inc.
Organization Subpart: NO
Active
NPI Number1194506113
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Long Term Care Pharmacy
Provider Details
NPI1194506113
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2023-10-06
Last Updated2023-10-06
Authorized OfficialTony Ibrahim
CEO
Phone: 7609876796
Mailing Address148 Morgan Way
Mount Shasta, CA 96067
United States
Phone: (530) 568-0270 | Fax: (530) 568-0271
📍 View Map
Primary Practice Address148 Morgan Way
Mount Shasta, CA 96067
United States
Phone: (530) 568-0270 | Fax: (530) 568-0271
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes3336L0003X – Pharmacy, Long Term Care Pharmacy--
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About NPI 1194506113

Mount Shasta Pharmacy, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1194506113. The primary specialty listed is Pharmacy, Long Term Care Pharmacy. The organization is located in Mount Shasta, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2023-10-06. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1194506113?

NPI 1194506113 belongs to Mount Shasta Pharmacy, Inc., a Pharmacy, Long Term Care Pharmacy in Mount Shasta, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1194506113 active?

The current status of NPI 1194506113 in the NPPES registry is Active. The record was last updated on 2023-10-06.

What specialty is NPI 1194506113?

NPI 1194506113 is classified under the taxonomy Pharmacy, Long Term Care Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1194506113?

You can verify NPI 1194506113 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1194506113?

The primary practice address on file for NPI 1194506113 is 148 Morgan Way, Mount Shasta, CA 96067. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1194506113 issued?

NPI 1194506113 was first issued (enumerated) on 2023-10-06. The NPPES record was last updated on 2023-10-06.

Practice Location Map

Mount Shasta Pharmacy, Inc. is located at 148 Morgan Way, Mount Shasta, CA. Use the map below to find directions or verify the practice location.

📍 148 Morgan Way, Mount Shasta, CA 96067  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Mount Shasta Pharmacy, Inc.. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-07-13 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162