MEDICARE: MEGHAN TAYLOR MISTRIC PHARMD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835C0207X	Compounded Sterile Preparations Pharmacist	02644	LA
2	183500000X	Pharmacist	02644	LA

General Provider Information

NPI Number	:	1356297808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN TAYLOR MISTRIC PHARMD

Provider Business Mailing Address
First Line	:	275 DEVAL DR
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-1901
Country	:	US
Telephone Number	:	985-807-7587
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 GALLERIA DR
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2196
Country	:	US
Telephone Number	:	504-267-9876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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