MEDICARE: SAGEBRUSH HEALTH 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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1245938356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGEBRUSH HEALTH LLC

Provider Business Mailing Address
First Line	:	217 TORBETT ST STE 101
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99354-2667
Country	:	US
Telephone Number	:	509-427-1450
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 TORBETT ST STE 101
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99354-2667
Country	:	US
Telephone Number	:	509-427-1450
Fax Number	:	509-420-4224

Authorized Official
Title or Position	:	CLINIC ADMINISTRATOR
Name	:	REBECCA CANTU
Credential	:
Telephone Number	:	509-427-1454

Provider Enumeration Date	:	02/17/2023
Last Update Date	:	05/28/2024

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Directions to “SAGEBRUSH HEALTH LLC ” Practice Location

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