Provider Demographics
NPI:1518027226
Name:HAMLET HMA INC
Entity Type:Organization
Organization Name:HAMLET HMA INC
Other - Org Name:SANDHILLS REGIONAL MEDICAL CENTER-SANGER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-205-8104
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-1109
Mailing Address - Country:US
Mailing Address - Phone:910-205-8000
Mailing Address - Fax:910-205-8007
Practice Address - Street 1:936 CIRCLEWOOD DR
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-4526
Practice Address - Country:US
Practice Address - Phone:910-205-8000
Practice Address - Fax:910-205-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014NVMedicaid
NC235053AMedicare ID - Type UnspecifiedSANGER MEDICARE PART B G#