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Sage Memorial Hospital
Managed Care Organization Pharmacy in Ganado, Arizona
NPI 1447315494

Sage Memorial Hospital is a Managed Care Organization Pharmacy based in Ganado, AZ and is specialized in Managed Care Organization Pharmacy. Sage Memorial Hospital practices in Ganado, AZ. The NPI Number for Sage Memorial Hospital is 1447315494 and holds a License No. Y000758 (Arizona).

The current practice location address for Sage Memorial Hospital is Hwy 264 And 191, Ganado, AZ and can be reached out via phone at 928-755-4500 and via fax at 928-755-4659.

Location: Hwy 264 And 191, Ganado, AZ, 86505-0457
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1447315494
Provider Name
Sage Memorial Hospital
Credential
Provider Entity Type
Organization
Address
Hwy 264 And 191, Ganado, AZ, 86505-0457
Phone Number
928-755-4500
Fax Number
928-755-4659
Provider Enumeration Date
12/27/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0308949 01 NCPDP PROVIDER IDENTIFICATION NUMBER
021353 05 AZ
institution
Provider Business Practice Location Address Details
Address
Hwy 264 And 191
City
Ganado
State
Arizona
Zip
86505
Phone Number
928-755-4500
Fax Number
928-755-4659
person
Provider Business Mailing Address Details
Address
Hwy 264 And 191
City
Ganado
State
Arizona
Zip
86505
Phone Number
928-755-4500
Fax Number
928-755-4659
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
Clinic Pharmacy
Taxonomy
3336C0002X
License No.
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Definition
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Managed Care Organization Pharmacy
Taxonomy
3336M0003X
License No.
Y000758 (Arizona)
Definition
A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.
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