| NPI | 1750064622 |
|---|---|
| Doing Business As | MESA RIDGE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SAMUEL WILDE Owner/Manager 435-668-8867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-12-06 |