Provider Demographics
NPI:1083425086
Name:SGM MEDICAL CORPORATION
Entity type:Organization
Organization Name:SGM MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCCASKILL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:512-565-3744
Mailing Address - Street 1:601 S BOWEN ST STE 601
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7041
Mailing Address - Country:US
Mailing Address - Phone:512-565-3744
Mailing Address - Fax:
Practice Address - Street 1:601 S BOWEN ST STE 601
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7041
Practice Address - Country:US
Practice Address - Phone:512-565-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care