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NPI Code Detail

MEDICARE: SAGE HEALTH AT HOME LLC

MEDICARE: SAGE HEALTH AT HOME LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician
2207RG0300XGeriatric Medicine (Internal Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11790963502OTHERNPPES

General Provider Information

NPI Number : 1235838624
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAGE HEALTH AT HOME LLC
Provider Business Mailing Address
First Line : 3100 INTERSTATE NORTH CIR SE STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30339-2384
Country : US
Telephone Number : 678-888-3313
Fax Number : 678-888-4229
Provider Business Practice Location Address
First Line : 3100 INTERSTATE NORTH CIR SE STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30339-2384
Country : US
Telephone Number : 678-888-3313
Fax Number : 678-888-4229
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. CARLA MARIA PERISSINOTTO
Credential : MD
Telephone Number : 678-688-3313
Provider Enumeration Date : 02/24/2023
Last Update Date : 04/04/2024

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Directions to “SAGE HEALTH AT HOME LLC ” Practice Location

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