Organization
BESTCARE MESA
Active
Other names
Mesa Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASHOK POTHULA RPH (OWNER)
(575) 245-6372
Entity
Organization
Contact information
Practice address
1279 S 2ND ST, RATON, NM 87740-2234
(575) 245-6372
(575) 245-3291
Mailing address
1279 S 2ND ST, RATON, NM 87740-2234
(575) 447-7521
(575) 245-3291
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH00003652
NM
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52024300
—
NM
Enumeration date
01/06/2014
Last updated
03/20/2023
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