Healthcare Provider Details

I. General information

NPI: 1285851501
Provider Name (Legal Business Name): SANDHILLS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 W HAMLET AVE
HAMLET NC
28345-4523
US

IV. Provider business mailing address

1100 WEST HAMLET AVENUE
HAMLET NC
28345-4524
US

V. Phone/Fax

Practice location:
  • Phone: 910-582-2613
  • Fax:
Mailing address:
  • Phone: 910-582-2613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number8566
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3400106
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 2
Identifier00240
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerBCBS

VIII. Authorized Official

Name: MR. ANDY DAVIS
Title or Position: CEO
Credential:
Phone: 910-205-8106