Meridian Pharmacy Management Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1-5132 Issued in OK

Legal business name

MERIDIAN PHARMACY MANAGEMENT INC

Doing business as

MEDIC PHARMACY HEFNER POINTE

Practice address

11101 Hefner Pointe Dr
Ste 101
Oklahoma City, OK 73120-0600

Phone

(405) 755-3921

Fax

(405) 755-3922

NPI assigned

Jul 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clay MooreNPI 1972060366

Title

Owner

Phone

(405) 755-3921

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• MEDIC PHARMACY HEFNER POINTE Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clay W. Moore, D.PH.

  • Pharmacist
  • Oklahoma City, OK
  • NPI 1972060366
  NPD Authorized official
• Mary Jane Fry, PHARM D.

  • Pharmacist
  • Oklahoma City, OK
  • NPI 1023672144
  NPD (past)
• Jonathan Patrick Hanna, PHARM. D.

  • Pharmacist
  • Oklahoma City, OK
  • NPI 1215406962
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1821014655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 HEFNER POINTE DR",
            "address_2": "STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731200600",
            "telephone_number": "405-755-3921",
            "fax_number": "405-755-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 HEFNER POINTE DR",
            "address_2": "STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731200600",
            "telephone_number": "405-755-3921",
            "fax_number": "405-755-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN PHARMACY MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CLAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-755-3921"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-5132",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074279",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100245800A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIC PHARMACY HEFNER POINTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harshitha Mergey Devender, MBBS
• Marci Deann Merideth Parker, BS
• Peesha Nidia Merideth, LD
• Meridian Clinic, Inc
• Meridian Family Practice, LLC
• Autumn Leigh Merilatt Ms, RDN LD MS
• Shirlin Merisier
• Glenda Merkley
• Merly Mathew, LLC
• Madilyn Merrell

• Community/Retail Pharmacy in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.