=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285079053
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN ELIZABETH LEWIS PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2013
-----------------------------------------------------
Last Update Date | 01/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 803 JAMESTOWN ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42728-1009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-384-0539
-----------------------------------------------------
Fax | 270-385-9132
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 803 JAMESTOWN ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42728-1009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-384-0538
-----------------------------------------------------
Fax | 270-385-9132
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | I10311
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | S10612
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 018668
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------