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General NPI Number Information
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NPI Number | 1457972754
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Entity Type | Organization
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Legal Business Name | SG PHARMA INC
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 4905 STOCKDALE HWY
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2637
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Country | US
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Telephone | 661-489-3500
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Fax | 661-489-3553
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Provider Business Mailing Address
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Address Line | 4905 STOCKDALE HWY
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2637
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Country | US
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Telephone | 661-489-3500
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Fax | 661-489-3553
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Authorized Official
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Title or Position | CEO
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Name | EBRAM TAWDROUS
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Credential | PHARMACIST
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Telephone | 559-274-3234
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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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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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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