Provider Demographics
NPI:1417919713
Name:SANDHILLS WOMANCARE PA
Entity Type:Organization
Organization Name:SANDHILLS WOMANCARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:NTUBE
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-486-7006
Mailing Address - Street 1:3363 VILLAGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4508
Mailing Address - Country:US
Mailing Address - Phone:910-486-7006
Mailing Address - Fax:910-222-0401
Practice Address - Street 1:3363 VILLAGE DR.
Practice Address - Street 2:SUITE 200
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4508
Practice Address - Country:US
Practice Address - Phone:910-486-7006
Practice Address - Fax:910-222-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016A8OtherBCBS
NC89016A8Medicaid
NC016A8OtherBCBS