| NPI | 1972925279 |
|---|---|
| Doing Business As | MESA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ASHOK POTHULA Owner 575-245-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NM PH00003652) |
| 333600000X Pharmacy | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2023-03-20 |