Provider Demographics
NPI:1568599975
Name:SANDS FAMILY MEDICINE PA
Entity Type:Organization
Organization Name:SANDS FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:ARENAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-895-0680
Mailing Address - Street 1:119 MEDICAL CIRCLE
Mailing Address - Street 2:SANDS FAMILY MEDICINE PA
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379
Mailing Address - Country:US
Mailing Address - Phone:910-895-0680
Mailing Address - Fax:910-997-7679
Practice Address - Street 1:119 MEDICAL CIRCLE
Practice Address - Street 2:SANDS FAMILY MEDICINE PA
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379
Practice Address - Country:US
Practice Address - Phone:910-895-0680
Practice Address - Fax:910-997-7679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910005Medicaid
NC10005OtherBCBS
NC8910005Medicaid
2172611Medicare ID - Type Unspecified