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General NPI Number Information
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NPI Number | 1255323234
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Entity Type | Organization
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Legal Business Name | SAGE-LANZ INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 5015 MAIN ST
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City | STEPHENS CITY
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State | VA
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Zip | 22655-3003
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Country | US
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Telephone | 540-869-1660
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Fax | 540-869-1463
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Provider Business Mailing Address
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Address Line | 5015 MAIN ST
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City | STEPHENS CITY
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State | VA
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Zip | 22655-3003
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Country | US
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Telephone | 540-869-1660
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Fax | 540-869-1463
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Authorized Official
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Title or Position | OWNER PIC
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Name | KEITH LANTZ
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Credential |
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Telephone | 540-869-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201002810
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License Number State | VA
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