Organization
SAGE PHARMACY AND STORES LLC
Active
Organization
SAGE PHARMACY AND STORES LLC
Active
Other names
SAGE PHARMACY AND STORES, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SURVAM PATEL (PRESIDENT)
(512) 628-1090
Entity
Organization
Contact information
Practice address
2500 S LAKELINE BLVD STE 202, CEDAR PARK, TX 78613-2969
(512) 628-1090
(512) 628-1090
Mailing address
2500 S LAKELINE BLVD STE 202, CEDAR PARK, TX 78613-2969
(512) 628-1090
(512) 628-1090
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
27581
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148225
—
TX
01
—
2131770
PK
—
Enumeration date
05/10/2011
Last updated
10/20/2023
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