Organization
BGH PHARMACY
Active
Other names
BGH Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL AL FATLAWI (PIC/OWENR)
(623) 455-3368
Entity
Organization
Contact information
Practice address
3544 W GLENDALE AVE STE E, PHOENIX, AZ 85051-8359
(623) 455-3368
(623) 243-5314
Mailing address
3544 W GLENDALE AVE, SUITE E, PHOENIX, AZ 85051-8359
(623) 455-3368
(623) 243-5314
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
Y006953
AZ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166064
PK
—
Enumeration date
08/31/2016
Last updated
11/08/2016
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