Provider Demographics
NPI:1952092355
Name:CONTIGO PHARMACEUTICALS INC.
Entity Type:Organization
Organization Name:CONTIGO PHARMACEUTICALS INC.
Other - Org Name:CONTIGO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-881-3119
Mailing Address - Street 1:2638 S CALAVERAS PL
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7003
Mailing Address - Country:US
Mailing Address - Phone:818-923-3787
Mailing Address - Fax:
Practice Address - Street 1:14960 BEAR VALLEY RD STE E
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-9248
Practice Address - Country:US
Practice Address - Phone:760-881-3119
Practice Address - Fax:760-881-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy