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General NPI Number Information
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NPI Number | 1508925264
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Entity Type | Organization
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Legal Business Name | SAGE SYSTEMS INC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 HAND AVENUE SUITE L
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-615-9049
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Fax | 386-615-2027
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Provider Business Mailing Address
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Address Line | 1400 HAND AVENUE SUITE L
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-615-9049
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Fax | 386-615-2027
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Authorized Official
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Title or Position | CEO
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Name | MR. E MARTIN HECKLINGER
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Credential |
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Telephone | 386-615-9049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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