Mesa Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH02484 Issued in NV

Legal business name

MESA PHARMACY INC

Practice address

4079 Spring Mountain Rd
Las Vegas, NV 89102-8614

Phone

(702) 876-2273

Fax

(702) 871-2755

NPI assigned

Feb 12, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew DO

Title

President/Ceo

Phone

(702) 354-7578

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• rx discount pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1457590580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18013 SKY PARK CIR",
            "address_2": "STE D",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146518",
            "telephone_number": "949-955-2975",
            "fax_number": "949-955-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4079 SPRING MOUNTAIN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028614",
            "telephone_number": "702-876-2273",
            "fax_number": "702-871-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "702-354-7578"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH02484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2991621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "rx discount pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yudaimy Mesa Granados
• Benjamin Mesa Hidalgo
• Carlos Mesa Hidalgo
• Adela Mesa Lopez
• Jocelyn Mesa Lopez
• Daily Mesa Sebasco
• Danelis Mesa Sebasco
• Martha Cecilia Mesa-Gomez
• Leonardo Mesa-Torres
• Eugenia Mesa

• Community/Retail Pharmacy in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Retail Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.