Mesa Ridge, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MESA RIDGE, LLC

Doing business as

Mesa Ridge Pharmacy

Practice address

340 Falcon Ridge Pkwy Ste 403
Mesquite, NV 89027-8851

Phone

(725) 253-0103

Fax

(725) 253-0104

NPI assigned

Jan 21, 2025

Last updated

Jan 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Michael Wilde, PHARMDNPI 1346929320

Title

Owner

Phone

(725) 253-0103

Specialties & licenses 1

Addresses

Other names 1

• Mesa Ridge Pharmacy Doing business as

Tax ID family

Mesa Ridge LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mesa Ridge, LLC

  dba Mesa Ridge Pharmacy

  • Community/Retail Pharmacy
  • Mesquite, NV
  • NPI 1750064622
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Michael Wilde, PHARMD

  • Pharmacist
  • Mesquite, NV
  • NPI 1346929320
  NPD Authorized official

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1497567143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 FALCON RIDGE PKWY STE 403",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278851",
            "telephone_number": "725-253-0103",
            "fax_number": "725-253-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 FALCON RIDGE PKWY STE 403",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278851",
            "telephone_number": "725-253-0103",
            "fax_number": "725-253-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "725-253-0103",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Ridge Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rita Maria Mejia-Braeckevelt, DO
• Kimberly Anne Melle
• Kyle D. Memmott, MPT
• Jeromy Ron Mendenhall, PA
• Mercy Air Service, Inc.
• Mesa Ridge, LLC (Mesa Ridge Pharmacy)
• Mesa View Home Care
• Mesa View Home Care, LLC
• Mesa View Hospice, LLC
• Mesa View Physical Rehabilitation, LLC

• Long Term Care Pharmacy in Mesquite, NV
• Providers in Mesquite, NV by specialty
• Long Term Care Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.