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General NPI Number Information
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NPI Number | 1194013714
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Entity Type | Organization
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Legal Business Name | SAGE SERVICES LLC
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Dates
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Enumeration Date | 07/17/2011
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Last Update Date | 07/17/2011
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Provider Practice Location Address
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Address Line | 481 RIO RANCHO DR NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-1421
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Country | US
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Telephone | 505-349-0464
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45803
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City | RIO RANCHO
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State | NM
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Zip | 87174-5803
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Country | US
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Telephone | 505-349-0464
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. SALLY A REEVES
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Credential |
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Telephone | 505-349-0464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 24336751
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License Number State | NM
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