Organization
MARI-MINA PHARMACEUTICALS INC
Active
Other names
Del's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEH ROKES RPH (PRESIDENT)
(909) 465-9282
Entity
Organization
Contact information
Practice address
10700 JERSEY BLVD, 330-340, RANCHO CUCAMONGA, CA 91730-5116
(909) 948-0206
(909) 948-0075
Mailing address
10700 JERSEY BLVD, 330-340, RANCHO CUCAMONGA, CA 91730-5116
(909) 948-0206
(909) 948-0075
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY49807
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013934876
—
CA
01
—
2000992
PK
—
Enumeration date
07/17/2006
Last updated
04/20/2017
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