MEDICARE: SANDHILLS FAMILY PRACTICE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	02286	OTHER	NC	BCBSNC PROVIDER NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780653279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDHILLS FAMILY PRACTICE PA

Provider Business Mailing Address
First Line	:	1125 CARTHAGE ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-4162
Country	:	US
Telephone Number	:	919-774-6023
Fax Number	:	919-776-6359

Provider Business Practice Location Address
First Line	:	1125 CARTHAGE ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-4162
Country	:	US
Telephone Number	:	919-774-6023
Fax Number	:	919-776-6359

Authorized Official
Title or Position	:	INSURANCE MANAGER
Name	:	MRS. ROBIN M THOMPSON
Credential	:	CMOM
Telephone Number	:	919-774-6023

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	03/15/2013

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Directions to “SANDHILLS FAMILY PRACTICE PA ” Practice Location

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