Provider Demographics
NPI:1629495494
Name:SAGE SPECIALTY CARE, INC
Entity type:Organization
Organization Name:SAGE SPECIALTY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-369-7200
Mailing Address - Street 1:7111 PROSPECT PL NE STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4337
Mailing Address - Country:US
Mailing Address - Phone:505-369-7200
Mailing Address - Fax:505-796-6154
Practice Address - Street 1:7111 PROSPECT PL NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4337
Practice Address - Country:US
Practice Address - Phone:505-369-7200
Practice Address - Fax:505-796-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03287932006261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center