Provider Demographics
NPI:1093483455
Name:SANDSTONE PRIMARY CARE, L.L.C.
Entity Type:Organization
Organization Name:SANDSTONE PRIMARY CARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:AMEDEE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:240-284-2238
Mailing Address - Street 1:133 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-1336
Mailing Address - Country:US
Mailing Address - Phone:240-284-2238
Mailing Address - Fax:240-284-2852
Practice Address - Street 1:133 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1336
Practice Address - Country:US
Practice Address - Phone:240-284-2238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care