Sage Memorial Hospital
LBN: Sage Memorial Hospital
Sage Memorial Hospital is an health care organization with primary practice located at Hwy 264 And 191 , Ganado AZ 86505. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Clinic Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty.
Sage Memorial Hospital can be contacted via phone (928) 755-4500, or through Kiyarash, Farid via phone (928) 755-4500.
Contact Information
Primary practice address
Hwy 264 And 191
Ganado AZ 86505
Phone: (928) 755-4500
Fax: (928) 755-4659
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Clinic Pharmacy | 3336C0002X | Y000758 | Arizona |
| Suppliers / Managed Care Organization Pharmacy | 3336M0003X |
Profile Details
| NPI number | 1447315494 |
|---|---|
| LBN Legal business name | Sage Memorial Hospital |
| DBA Doing business as | Sage Memorial Hospital |
| Authorized official | Kiyarash, Farid |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Jun 9th, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447315494 | NPPES |
| Other | 0308949 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 021353 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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