Organization
MESA RIDGE, LLC
Active
Other names
Mesa Ridge Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MICHAEL WILDE PHARMD (OWNER)
(725) 253-0103
Entity
Organization
Contact information
Practice address
340 FALCON RIDGE PKWY STE 403, MESQUITE, NV 89027-8851
(725) 253-0103
(725) 253-0104
Mailing address
340 FALCON RIDGE PKWY STE 403, MESQUITE, NV 89027-8851
(725) 253-0103
(725) 253-0104
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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