=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285430074
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN FLEURY PHARMD, RP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2025
-----------------------------------------------------
Last Update Date | 02/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17500 BURKE ST
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68118-2244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-401-3577
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16402 POTTER ST
-----------------------------------------------------
City | BENNINGTON
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68007-1675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 16513
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------