Organization Active NPI

Contigo Pharmaceuticals Inc.

  • Pharmacy
  • Victorville, CA
National Provider Identifier
1952092355
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CONTIGO PHARMACEUTICALS INC.
Practice address
14960 Bear Valley Rd Ste E
Victorville, CA 92395-9248
Phone
(760) 881-3119
Fax
(760) 881-3115
NPI assigned
May 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Mina MichaelNPI 1538657606
Title
Ceo
Phone
(760) 881-3119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

14960 Bear Valley Rd Ste E
Victorville, CA 92395-9248

Mailing address

2638 S Calaveras PL
Ontario, CA 91761-7003
Phone (818) 923-3787

Other names 1

  • Contigo Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240115000185 CA Part B Supplier - Pharmacy 7214389352 Practice locations: Victorville, CA
O20251208003001 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7214389352 Practice locations: Victorville, CA

National Provider Directory

National Provider Directory
Tax ID family
Contigo Pharmaceuticals 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.

Locations

14960 Bear Valley Rd
Ste E
Victorville, CA 92395
Phone (760) 881-3119

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1952092355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 S CALAVERAS PL",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617003",
            "telephone_number": "818-923-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14960 BEAR VALLEY RD STE E",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923959248",
            "telephone_number": "760-881-3119",
            "fax_number": "760-881-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTIGO PHARMACEUTICALS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-17",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-881-3119"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Contigo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.