Organization
PGBB LLC
Active
Other names
SPECIALTY CARE RX
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY GRIFFITH (MEMBER)
(949) 506-1300
Entity
Organization
Contact information
Practice address
200 E KATELLA AVE STE A, ORANGE, CA 92867-4805
(714) 941-6177
(714) 941-6178
Mailing address
200 E KATELLA AVE STE A, ORANGE, CA 92867-4805
(714) 941-6177
(714) 941-6178
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5643184
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
PHY59102
BOARD OF PHARMACY
CA
Enumeration date
03/19/2012
Last updated
10/09/2024
Update your record
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