Organization
MESA RIDGE, LLC
Active
Other names
Mesa Ridge Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WILDE PHARMD (OWNER/MANAGER)
(435) 668-8867
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
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
12/06/2023
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