Healthcare Provider Details

I. General information

NPI: 1174409494
Provider Name (Legal Business Name): MEGHAN ANNE SORRELLS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 S EAST ST
INDIANAPOLIS IN
46227-1416
US

IV. Provider business mailing address

8474 S NASH DR
NINEVEH IN
46164-9765
US

V. Phone/Fax

Practice location:
  • Phone: 317-781-4258
  • Fax: 317-781-4260
Mailing address:
  • Phone: 812-216-4147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26031203A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: