MESA GROUP LLC (NPI# 1790225795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790225795 |
| Entity Type | Organization |
| Organization Name | MESA GROUP LLC |
| Other Organization Name | MESA PHARMACY |
| Practice Address |
308 Colbert Ave Springer NM 87747 |
| Mailing Address |
1279 S 2nd St Raton NM 87740-2234 |
| Practice Telephone | 5754832288 |
| Practice Fax Number | 5754832295 |
| Mailing Telephone | 5752456372 |
| Mailing Fax Number | 5752453292 |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2019-12-26 |
| Authorized Official Name | KIM ATWATER (MANAGING MEMBER) |
| Authorized Official Telephone | 5754477521 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH00004380 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2168834 | 01 |
| Other Name | Type Code |
|---|---|
| Mesa Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972925279 | Mesa Group LLC | Durable Medical Equipment & Medical Supplies | 1279 S 2nd St, Raton, NM 87740-2234 | 2014-01-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MESA GROUP LLC | 1520 Airport Rd, Arlington, OR 97812 |
| Street Address |
308 COLBERT AVE |
| City | SPRINGER |
| State | NM |
| Zip Code | 87747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962050179 | Gayle Ann Bustos | Registered Nurse | 311 Miranda Ave., Springer, NM 87747 | 2019-08-30 |
| 1669930392 | El Centro Family Health | Clinic/Center | 1401 8th Street, Springer, NM 87747 | 2019-03-12 |
| 1831637636 | Bestcare Pharmacy Springer LLC | Pharmacy | 307 Maxwell Ave, #b, Springer, NM 87747 | 2017-02-01 |
| 1629233317 | El Centro Family Health | Clinic/Center | 502 4th Street, Springer, NM 87747 | 2008-07-23 |
| 1043393077 | Tony Pesavento | Pharmacy | 825 4th Street, Springer, NM 87747 | 2006-10-23 |
| 1215941380 | Patricia Anne Whitman | Nurse Practitioner | 200 Cimarron, Springer, NM 87747 | 2006-07-27 |
| 1447216619 | Jo Anne Jackson | Speech-Language Pathologist | 1401 8th St., Springer, NM 87747 | 2006-04-25 |
| 1508842758 | Presbyterian Healthcare Services | Emergency Medicine | 615 Prospect Ave, Springer, NM 87747 | 2005-12-20 |
| 1073749487 | South Central Colfax County Special Hospital District | Nursing Facility/Intermediate Care Facility | 615 Prospect Ave, Springer, NM 87747 | 2009-06-01 |
| 1588890909 | South Central Colfax County Special Hospital District | Clinical Medical Laboratory | 615 Prospect Ave, Springer, NM 87747 | 2009-06-01 |
| Find all providers in zip 87747 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043393077 | Tony Pesavento | Pharmacy | 825 4th Street, Springer, NM 87747 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316390 | Cynthia Lois Meyers | Pharmacy | 2709 Cerrillos Road, Santa Fe, NM 87507 | 2020-11-03 |
| 1790384261 | Mt. Cristo Pharmacy LLC | Pharmacy | 1155 Mcnutt Rd Ste 110, Sunland Park, NM 88063-9175 | 2020-10-25 |
| 1497362214 | Farmers Pharmacy Market LLC | Pharmacy | 501 W 18th St # 7233, Portales, NM 88130-7233 | 2020-09-25 |
| 1912512088 | Zia Family Health and Pharmacy | Pharmacy | 305 E Sanger St Ste F, Hobbs, NM 88240-4405 | 2020-09-15 |
| 1043705890 | Albrighton Pharmacy | Pharmacy | 401 Anthony Dr Ste E, Anthony, NM 88021 | 2018-06-25 |
| 1730677576 | Allan Yeh | Pharmacy | 1003 10th St, Alamogordo, NM 88310-6425 | 2018-04-26 |
| 1912425109 | Bestcare Pharmacy Deming | Pharmacy | 812 E Florida St, Deming, NM 88030-5312 | 2017-09-07 |
| 1710404355 | Del-rey Pharmacy LLC | Pharmacy | 3291 Del Rey Blvd Ste 3, Las Cruces, NM 88012-5045 | 2017-08-24 |
| 1457877425 | Dorado Sf Ltd | Pharmacy | 7 Caliente Rd, Santa Fe, NM 87508-3102 | 2017-08-21 |
| 1336665439 | Bryan Yamashita | Pharmacy | 7215 Primrose Dr Nw, Albuquerque, NM 87120-5277 | 2017-08-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.