Provider Demographics
NPI:1447379938
Name:SANDHILLS MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:SANDHILLS MEDICAL FOUNDATION
Other - Org Name:SANDHILLS MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NORWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-438-5537
Mailing Address - Street 1:1165 HWY 1 SOUTH
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-8966
Mailing Address - Country:US
Mailing Address - Phone:803-438-5537
Mailing Address - Fax:803-438-5546
Practice Address - Street 1:1165 HIGHWAY 1 S
Practice Address - Street 2:SUITE 400
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-8966
Practice Address - Country:US
Practice Address - Phone:803-438-5537
Practice Address - Fax:803-438-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC784674Medicaid
SC4226139OtherNCPDP