Organization
SG PHARMACY INC
Active
Organization
SG PHARMACY INC
Active
Other names
BROTMAN MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAPAN BHAKTA RPH (PHCY MANG)
(909) 225-0283
Entity
Organization
Contact information
Practice address
3831 HUGHES AVE, CULVER CITY, CA 90232-2751
(310) 204-1111
(310) 204-0295
Mailing address
3831 HUGHES AVE, CULVER CITY, CA 90232-2751
(310) 204-1111
(310) 204-0295
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
48890
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1999031
PK
—
Enumeration date
07/30/2006
Last updated
07/07/2016
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