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Organization

MESA PHARMACY INC

Active
Other names
Mesa Pharmacy III
Organization subpart
No

Provider details

NPI number
Authorized official
ANDY DO (PRESIDENT/PIC)
(702) 354-7578
Entity
Organization

Contact information

Practice address
1900 ROYALTY DR STE 190, POMONA, CA 91767-3050
(909) 623-8600
(909) 623-8686
Mailing address
1900 ROYALTY DR, SUITE 190, POMONA, CA 91767-3032
(909) 623-8600
(909) 623-8686

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50767
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5616935
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
08/31/2006
Last updated
01/24/2012
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