Provider Demographics
NPI:1578794160
Name:NEDA GLOBAL INC
Entity Type:Organization
Organization Name:NEDA GLOBAL INC
Other - Org Name:MEADOWBROOK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RASUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-451-6900
Mailing Address - Street 1:6624 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-5241
Mailing Address - Country:US
Mailing Address - Phone:817-451-6900
Mailing Address - Fax:817-451-6901
Practice Address - Street 1:6624 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-5241
Practice Address - Country:US
Practice Address - Phone:817-451-6900
Practice Address - Fax:817-451-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146048Medicaid
2121298OtherPK