Provider Demographics
NPI:1700620689
Name:WEIR, JONATHON (PHARMD)
Entity type:Individual
Prefix:
First Name:JONATHON
Middle Name:
Last Name:WEIR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12122 N RANCHO VISTOSO BLVD
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1749
Mailing Address - Country:US
Mailing Address - Phone:520-297-0260
Mailing Address - Fax:520-297-4080
Practice Address - Street 1:12122 N RANCHO VISTOSO BLVD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1749
Practice Address - Country:US
Practice Address - Phone:520-297-0260
Practice Address - Fax:520-297-4080
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS027031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist