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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