Organization
SOUTH GATE ROSE PHCY INC
Active
Other names
BLUE ROSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIER ZAMORA (CFO)
(714) 350-3009
Entity
Organization
Contact information
Practice address
8615 KNOTT AVE, STE 7, BUENA PARK, CA 90620-3841
(714) 952-4978
(714) 953-6868
Mailing address
8615 KNOTT AVE, STE 7, BUENA PARK, CA 90620-3841
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PHY47605
CA
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622990
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us