Provider Demographics
NPI:1578904967
Name:FAUX, WESSTON FORD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WESSTON
Middle Name:FORD
Last Name:FAUX
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 1:4711 CARLILE DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4567
Mailing Address - Country:US
Mailing Address - Phone:801-554-5187
Mailing Address - Fax:
Practice Address - Street 1:333 W CENTER ST
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3243
Practice Address - Country:US
Practice Address - Phone:208-233-2063
Practice Address - Fax:208-233-6158
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0013590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist