Organization
SAGE MEDICAL GROUP LLC
Active
Other names
Sage Medical Group Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES D MOSES (CHIEF ADMINISTRATIVE OFFICER)
(307) 265-8300
Entity
Organization
Contact information
Practice address
419 S WASHINGTON STREET, SUITE 201, CASPER, WY 82601
(307) 265-8300
(307) 265-8313
Mailing address
PO BOX 50750, CASPER, WY 82605
(307) 265-8300
(307) 265-8313
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
WY
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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