=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457236515
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MERIDIAN PHARMACY GROUP AT LANCASTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2025
-----------------------------------------------------
Last Update Date | 08/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2505 W BELT LINE RD
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75146-1930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-951-0133
-----------------------------------------------------
Fax | 214-765-9240
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1341 W MOCKINGBIRD LN STE 500 W 1341 W MOCKINGBIRD LN
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75247-7524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-937-6676
-----------------------------------------------------
Fax | 214-765-9240
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER/PHARMACIST
-----------------------------------------------------
Name | PAMELA ASHU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-937-6676
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------