=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558208520
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELINA MEHIC PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2026
-----------------------------------------------------
Last Update Date | 04/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5215 HOLY CROSS PKWY
-----------------------------------------------------
City | MISHAWAKA
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46545-1469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-335-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 628 SPRINGBROOK RD
-----------------------------------------------------
City | FORT WAYNE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46825-3642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 260-435-0775
-----------------------------------------------------
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 | 45023580A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------