Organization
SAGE-LANZ INC
Active
Other names
LANTZS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH LANTZ (OWNER PIC)
(540) 869-1660
Entity
Organization
Contact information
Practice address
5015 MAIN ST, STEPHENS CITY, VA 22655-3003
(540) 869-1660
(540) 869-1463
Mailing address
5015 MAIN ST, STEPHENS CITY, VA 22655-3003
(540) 869-1660
(540) 869-1463
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201002810
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4824252
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
8500649
—
VA
Enumeration date
08/16/2005
Last updated
04/19/2012
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