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General NPI Number Information
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NPI Number | 1205203874
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Entity Type | Organization
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Legal Business Name | SOUTH GATE PHARMACY INC
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Dates
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Enumeration Date | 08/29/2015
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 8200 LONG BEACH BLVD UNIT D-2
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City | SOUTH GATE
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State | CA
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Zip | 90280-2057
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Country | US
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Telephone | 323-537-2837
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Fax | 323-537-4940
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Provider Business Mailing Address
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Address Line | 8200 LONG BEACH BLVD UNIT D-2
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City | SOUTH GATE
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State | CA
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Zip | 90280-2057
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Country | US
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Telephone | 323-537-2837
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Fax | 323-537-4940
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | PARESH DHANJIBHAI PATEL
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Credential |
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Telephone | 323-537-2837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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