SAGE MEMORIAL HOSPITAL; NPI #1447315494

Contact Information

SAGE MEMORIAL HOSPITAL

HWY 264 AND 191
GANADO, AZ 86505

Phone: 928-755-4500
Fax: 928-755-4659
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Clinic Pharmacy	3336C0002X	58	Medical Supply Company with Pharmacist
Managed Care Organization Pharmacy	3336M0003X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for SAGE MEMORIAL HOSPITAL

NPI # 1447315494

LBN Legal business name SAGE MEMORIAL HOSPITAL

Authorized official FARID KIYARASH - (DIR OF PHCY)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/27/2006

Last updated 06/09/2009 - About 17 years ago

Identifiers

AZ	License #	Y000758
AZ	Medicaid	021353
	Other	0308949	NCPDP PROVIDER IDENTIFICATION NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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SAGE MEMORIAL HOSPITAL

Contact Information

Specialty

Clinic Pharmacy

Managed Care Organization Pharmacy

NPI Profile & details for SAGE MEMORIAL HOSPITAL

Reviews for SAGE MEMORIAL HOSPITAL