Sage Pharmacy and Stores LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAGE PHARMACY AND STORES LLC

Practice address

2500 S Lakeline Blvd Ste 202
Cedar Park, TX 78613-2969

Phone

(512) 628-1090

Fax

(512) 628-1090

NPI assigned

May 10, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Survam Patel

Title

President

Phone

(512) 628-1090

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SAGE PHARMACY AND STORES, LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Calissta Johnson, PHARMD

  • Nutrition Support Pharmacist
  • Cedar Park, TX
  • NPI 1619543394
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1023300084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S LAKELINE BLVD STE 202",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132969",
            "telephone_number": "512-628-1090",
            "fax_number": "512-628-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S LAKELINE BLVD STE 202",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132969",
            "telephone_number": "512-628-1090",
            "fax_number": "512-628-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE PHARMACY AND STORES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SURVAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-628-1090"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "27581",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148225",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131770",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAGE PHARMACY AND STORES, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAGE PHARMACY AND STORES, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Rybarski, RNFA
• Nicole Catherine Ryman, MD
• Rynoman
• Claire Stephanie Saca, MS, CCC-SLP
• Azalea Saemi, M.D.
• Sagebrook Health Center Inc
• Sagebrook Health Center Inc
• Sagebrook SCC, LLC
• Ryan Lee Sagraves, CPHT
• Melissa Sailor

• Community/Retail Pharmacy in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.