MEDICARE: MERIDIAN PHARMACY GROUP NW HIGHWAY INC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1841161981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN PHARMACY GROUP NW HIGHWAY INC

Provider Business Mailing Address
First Line	:	1341 W MOCKINGBIRD LN STE 500W
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-6903
Country	:	US
Telephone Number	:	817-937-6676
Fax Number	:	214-765-9240

Provider Business Practice Location Address
First Line	:	1120 E PLEASANT RUN RD STE 405
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-3512
Country	:	US
Telephone Number	:	214-333-1600
Fax Number	:	214-333-1609

Authorized Official
Title or Position	:	PARTNER/PHARMACIST
Name	:	MS. PAMELA ASHU
Credential	:	RPH
Telephone Number	:	817-937-6676

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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