{
"Npi": {
"NPI": "1841161981",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "MERIDIAN PHARMACY GROUP NW HIGHWAY INC",
"ParentOrgTIN": null,
"OrgName": "MERIDIAN PHARMACY GROUP NW HIGHWAY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1341 W MOCKINGBIRD LN STE 500W",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75247-6903",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-937-6676",
"MailingAddressFaxNumber": "214-765-9240",
"FirstLinePracticeLocationAddress": "1120 E PLEASANT RUN RD STE 405",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DESOTO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75115-3512",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-333-1600",
"PracticeLocationAddressFaxNumber": "214-333-1609",
"EnumerationDate": "09/12/2025",
"LastUpdateDate": "09/12/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ASHU",
"AuthorizedOfficialFirstName": "PAMELA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PARTNER/PHARMACIST",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "817-937-6676",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}