Organization
SGP INC
Active
Other names
PROFESSIONAL PRESCRIPTION PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHILENA LONG (PHCY MGR)
(568) 426-7664
Entity
Organization
Contact information
Practice address
2863 ATLANTIC AVE, LONG BEACH, CA 90806-1713
(562) 426-7664
(562) 426-1148
Mailing address
2863 ATLANTIC AVE, LONG BEACH, CA 90806-1713
(562) 426-7664
(562) 426-1148
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47176
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1993224
PK
—
05
—
PHA300530
—
CA
Enumeration date
07/22/2006
Last updated
12/01/2016
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