Provider Demographics
NPI:1346381852
Name:SAB GROUP INC.
Entity Type:Organization
Organization Name:SAB GROUP INC.
Other - Org Name:SAB MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SKULSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-250-0953
Mailing Address - Street 1:55 ADDIS DR
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1167
Mailing Address - Country:US
Mailing Address - Phone:267-250-0953
Mailing Address - Fax:215-942-0862
Practice Address - Street 1:55 ADDIS DR
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:PA
Practice Address - Zip Code:18966-1167
Practice Address - Country:US
Practice Address - Phone:267-250-0953
Practice Address - Fax:215-942-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA42530246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA051340Medicare ID - Type UnspecifiedIDTF