# SOUTHGATE ROSE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BLUEROSE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528144664
- **Authorized official:** MRS. ROSSMARI R RAMOS-ZAMORA (CEO)
- **Authorized official phone:** (714) 953-6861

## Contact information

- **Practice address:** 8615 KNOTT AVE, SUITE \#7, BUENA PARK, CA 90620-3841
- **Practice address phone:** (714) 952-4978
- **Practice address fax:** (714) 952-4978
- **Mailing address:** 8615 KNOTT AVE, SUITE \#7, BUENA PARK, CA 90620-3841
- **Mailing address phone:** (714) 952-4978
- **Mailing address fax:** (714) 952-4978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0005X | Ambulatory Family Planning Facility | PHY47605 | CA | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 08/22/2020