Organization
MESA PHARMACY INC
Active
Other names
rx discount pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW DO (PRESIDENT/CEO)
(702) 354-7578
Entity
Organization
Contact information
Practice address
4079 SPRING MOUNTAIN RD, LAS VEGAS, NV 89102-8614
(702) 876-2273
(702) 871-2755
Mailing address
18013 SKY PARK CIR, STE D, IRVINE, CA 92614-6518
(949) 955-2975
(949) 955-2925
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH02484
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2991621
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/12/2009
Last updated
06/22/2010
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