Provider Demographics
NPI:1972475820
Name:SG PHARMACY INC
Entity type:Organization
Organization Name:SG PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEUNGKYU
Authorized Official - Middle Name:
Authorized Official - Last Name:GIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-300-4767
Mailing Address - Street 1:249 BROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650
Mailing Address - Country:US
Mailing Address - Phone:201-300-4767
Mailing Address - Fax:201-300-4768
Practice Address - Street 1:249 BROAD AVENUE
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650
Practice Address - Country:US
Practice Address - Phone:201-300-4767
Practice Address - Fax:201-300-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy