Organization
SGP INCORPORATED
Active
Other names
LAS PHARMACY AND MEDICAL EQUIPMENT
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY LONG (PRESIDENT)
(323) 771-2633
Entity
Organization
Contact information
Practice address
7705 S ATLANTIC BLVD, H, CUDAHY, CA 90201
(323) 771-2633
(323) 771-1718
Mailing address
7705 S ATLANTIC BLVD, H, CUDAHY, CA 90201
(323) 771-2633
(323) 771-1718
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
49169
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1993883
PK
—
Enumeration date
11/01/2006
Last updated
06/09/2016
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