Mari-Mina Pharmaceuticals Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

50935 Issued in CA

Legal business name

MARI-MINA PHARMACEUTICALS INC

Practice address

10374 Trademark St
Rancho Cucamonga, CA 91730-5824

Phone

(909) 477-6300

Fax

(909) 477-3009

NPI assigned

Sep 18, 2012

Organization subpart

No

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

Authorized official

Name

Noha KoltaNPI 1770212177

Title

Pic

Phone

(909) 477-6300

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Del's Pharmacy I Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

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

Del'S Pharmacy I2 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.

• Mari-Mina Pharmaceuticals Inc

  • Community/Retail Pharmacy
  • Duarte, CA
  • NPI 1831449107
  NPD tax ID

Locations

Practitioners 3

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

• Noha Kolta, RPH

  • Pharmacist
  • Rancho Cucamonga, CA
  • NPI 1770212177
  NPD (past) Authorized official
• Michael Habashy

  • Pharmacist
  • Rancho Cucamonga, CA
  • NPI 1528648151
  NPD (past)
• Moheb Kaldas, RPH

  • Pharmacist
  • Rancho Cucamonga, CA
  • NPI 1124579412
  NPD (past)

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1730439779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10374 TRADEMARK ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305824",
            "telephone_number": "909-477-6300",
            "fax_number": "909-477-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10374 TRADEMARK ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305824",
            "telephone_number": "909-477-6300",
            "fax_number": "909-477-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARI-MINA PHARMACEUTICALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-18",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "KOLTA",
        "authorized_official_first_name": "NOHA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "909-477-6300"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "50935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136926",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del's Pharmacy I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie Marbach, RN
• Chamada March
• Mark Marella
• Oscar C Marella, R.P.T
• Mari-Mina Pharmaceuticals Inc
• Olga Maria
• Ed Carlo Hernandez Mariano
• Maricel Domiquel
• Jenny Marin Le
• Crystal Denise Marin

• Long Term Care Pharmacy in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.