St Mina Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

50685 Issued in CA

Legal business name

ST MINA INC

Practice address

8110 Mango Ave Ste 105
Fontana, CA 92335-3603

Phone

(909) 350-3200

Fax

(909) 350-3223

NPI assigned

Oct 7, 2011

Organization subpart

No

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

Authorized official

Name

Nader AbadierNPI 1326255647

Title

Secretary/Pharmacist

Phone

(909) 851-0311

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• St Mina pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• St Mina Inc

  • Community/Retail Pharmacy
  • Fontana, CA
  • NPI 1801290440

  O20220202002072

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

St Mina Inc2 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.

• St Mina Inc

  • Community/Retail Pharmacy
  • Fontana, CA
  • NPI 1801290440
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nader E Abadier, RPH

  • Pharmacist
  • Fontana, CA
  • NPI 1326255647
  NPD Authorized official
• Samia Hakim Abadier, RPH

  • Pharmacist
  • Fontana, CA
  • NPI 1548742836
  NPD (past)

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1447534573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7643 CABRILLO WAY",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928800923",
            "telephone_number": "909-350-3200",
            "fax_number": "909-350-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 MANGO AVE STE 105",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353603",
            "telephone_number": "909-350-3200",
            "fax_number": "909-350-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MINA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "ABADIER",
        "authorized_official_first_name": "NADER",
        "authorized_official_title_or_position": "SECRETARY/PHARMACIST",
        "authorized_official_telephone_number": "909-851-0311"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "50685",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132241",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447534573",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mina pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim L. Spencer, MD
• Marcia Spencer, LMFT
• Square Health, LLC
• Versha Kumari Srivastava, D.O.
• Patricia Grace Ssebakijje, BEHAVIOR TECHNICIAN
• St Mina Inc
• St. George Transportation Inc
• St. Jude Healing Home, LLC
• Vallory F Staley, PA
• Timothy Lawrence Standon, PA-C

• All providers in Fontana, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.