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Organization
MARI-MINA PHARMACEUTICALS INC
Active
Organization
MARI-MINA PHARMACEUTICALS INC
Active
Other names
Del's Pharmacy I
Organization subpart
No
Provider details
NPI number
Authorized official
NOHA KOLTA (PIC)
(909) 477-6300
Entity
Organization
Contact information
Practice address
10374 TRADEMARK ST, RANCHO CUCAMONGA, CA 91730-5824
(909) 477-6300
(909) 477-3009
Mailing address
10374 TRADEMARK ST, RANCHO CUCAMONGA, CA 91730-5824
(909) 477-6300
(909) 477-3009
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336H0001X
Home Infusion Therapy Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
50935
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136926
PK
—
Enumeration date
09/18/2012
Last updated
12/05/2016
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