Healthcare Provider Details

I. General information

NPI: 1699779504
Provider Name (Legal Business Name): AGMMM PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 09/19/2025
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5735 ATLANTIC AVE
LONG BEACH CA
90805-4712
US

IV. Provider business mailing address

5735 ATLANTIC AVE
LONG BEACH CA
90805-4712
US

V. Phone/Fax

Practice location:
  • Phone: 562-423-8437
  • Fax: 562-423-0137
Mailing address:
  • Phone: 562-423-8437
  • Fax: 562-423-0137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY51151
License Number StateCA

VIII. Authorized Official

Name: ATTEF GIRGIS
Title or Position: OWNER
Credential:
Phone: 562-423-8437