| NPI | 1497567143 |
|---|---|
| Doing Business As | MESA RIDGE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SAMUEL MICHAEL WILDE Owner 725-253-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |