MEDICARE: MERIDIAN HEALTH RX LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1356232169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN HEALTH RX LLC

Provider Business Mailing Address
First Line	:	1620 W NORTHWEST HWY STE 100
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-3219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 MCKINNIE AVE STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46806-4975
Country	:	US
Telephone Number	:	260-399-2332
Fax Number	:	260-399-9595

Authorized Official
Title or Position	:	CFO
Name	:	SCOTT RIGGS
Credential	:
Telephone Number	:	765-254-5189

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	04/16/2026

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Directions to “MERIDIAN HEALTH RX LLC ” Practice Location

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