MEDICARE: MERIANA NADROUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26028696A	IN

General Provider Information

NPI Number	:	1285238675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERIANA NADROUS

Provider Business Mailing Address
First Line	:	13006 TUSCANY WAY
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-8832
Country	:	US
Telephone Number	:	260-417-8481
Fax Number	:

Provider Business Practice Location Address
First Line	:	3918 S CALHOUN ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46807-2408
Country	:	US
Telephone Number	:	260-744-2310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	11/25/2020

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Directions to “ MERIANA NADROUS ” Practice Location

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