Organization
MELADIMAA PHARMACY LLC
Active
Other names
Baggett Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT LOUDERBACK (MANAGING MEMBER)
(402) 488-1184
Entity
Organization
Contact information
Practice address
2100 W WALNUT HILL LN STE 125A, IRVING, TX 75038-3220
(945) 279-6540
(945) 279-6541
Mailing address
300 S 68TH STREET PL STE 501, LINCOLN, NE 68510-2475
(402) 488-1184
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
06/16/2022
Last updated
01/15/2026
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