SAGE MEMORIAL HOSPITAL (NPI# 1447315494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447315494 |
| Entity Type | Organization |
| Organization Name | SAGE MEMORIAL HOSPITAL |
| Other Organization Name | SAGE MEMORIAL HOSPITAL |
| Practice Address |
Hwy 264 and 191 Ganado AZ 86505 |
| Mailing Address |
Po Box 457 Ganado AZ 86505-0457 |
| Practice Telephone | 9287554500 |
| Practice Fax Number | 9287554659 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2009-06-09 |
| Authorized Official Name | FARID KIYARASH (DIR OF PHCY) |
| Authorized Official Telephone | 9287554500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Y000758 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 021353 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 0308949 | 01 |
| Other Name | Type Code |
|---|---|
| SAGE MEMORIAL HOSPITAL | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SAGE MEMORIAL HOSPITAL | Hwy 264 & Junction 191, Ganado, AZ 86505 |
| Street Address |
HWY 264 AND 191 |
| City | GANADO |
| State | AZ |
| Zip Code | 86505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649889122 | Patricia Ann Blosser | Nurse Practitioner | Hwy 191 St Rt 264, Ganado, AZ 86505 | 2020-07-30 |
| 1164047536 | Erlinda Marie Miller | Respiratory Therapist, Certified | Sr 254 & Hwy 191, Ganado, AZ 86505 | 2020-06-11 |
| 1821637661 | Ernasha K. Mcintosh | Nurse Practitioner | Us 191 Az 264, Hc 58, Sage Memorial Hospital, Ganado, AZ 86505 | 2019-12-26 |
| 1578120622 | Tiffany Nicole Stevens | Physical Therapist | Highway 264 191 South, Sage Memorial Hospital, Gando, AZ 86505 | 2019-05-23 |
| 1649779661 | Cindy Lincoln | Social Worker | Arizona Highway 264 & 191 South, Ganado, AZ 86505 | 2018-02-05 |
| 1780113340 | Didi Marie Josea | Social Worker | 3.7 Miles Se of Mp 455 Hwy 264, Ganado, AZ 86505 | 2017-06-07 |
| 1902184757 | Chandara Im | Dentist | Arizona 264, Sage Memorial Hospital, Ganado, AZ 86505 | 2011-07-28 |
| 1407186778 | Aimee Marie Dosch | Physical Therapist | Juntion Rt. 264 and 191, Sage Memorial Hospital, Ganado, AZ 86505 | 2010-01-08 |
| 1346574399 | Mark Charles Schermerhorn | Speech-Language Pathologist | Sage Memorial Hospital, Hwy 264, Ganado, AZ 86505 | 2009-09-23 |
| 1548416134 | Timothy P Cousens Jr. | Physical Therapist | Highway 264 and 191 South, Navajo Health Foundation/sage Memorial Hospital/pt Dept, Ganado, AZ 86505 | 2008-08-14 |
| Find all providers in zip 86505 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154989168 | Community Hospital Association, Inc. | Pharmacy | 26750b S. Santa Fe Rd., Congress, AZ 85332 | 2019-06-04 |
| 1154688927 | Marana Health Center Inc | Pharmacy | 899 N Wilmot Rd Ste B, Tucson, AZ 85711-1712 | 2012-04-18 |
| 1245357706 | West Kingman Pharmacy, LLC | Pharmacy | 3135 N Stockton Hill Rd, Kingman, AZ 86401 | 2007-03-22 |
| 1649334442 | North Country Healthcare, Inc. | Pharmacy | 2920 North 4th Street, Flagstaff, AZ 86004 | 2006-12-19 |
| 1730295684 | State of Arizona | Pharmacy | 1295 N Martin, Tucson, AZ 85721-0001 | 2006-08-22 |
| 1023122843 | Cardiojost, Inc | Pharmacy | 140 S Power Rd Ste 102, Mesa, AZ 85206-5297 | 2006-08-18 |
| 1376502054 | Sunset Community Health Center Inc | Pharmacy | 815 E Cesar Chavez Blvd, San Luis, AZ 85349 | 2006-03-21 |
| 1275519241 | El Rio Health Center (southwest) | Pharmacy | 1510 W Commerce Court, Tucson, AZ 85746-6015 | 2005-12-21 |
| 1447242417 | Cigna Health Care of Arizona Inc | Pharmacy | 1920 E Baseline Rd, Tempe, AZ 85283-1511 | 2005-08-16 |
| 1992797930 | Cigna Health Care of Arizona Inc | Pharmacy | 9069 W Thunderbird, Peoria, AZ 85381 | 2005-08-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SAGE MEMORIAL HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.