Provider Demographics
NPI:1821681271
Name:SANDY SHORES MEDICAL CENTER AND URGENT CARE
Entity Type:Organization
Organization Name:SANDY SHORES MEDICAL CENTER AND URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:910-271-7317
Mailing Address - Street 1:13741 NC HIGHWAY 50 STE A
Mailing Address - Street 2:
Mailing Address - City:SURF CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28445-6935
Mailing Address - Country:US
Mailing Address - Phone:910-777-2732
Mailing Address - Fax:
Practice Address - Street 1:13741 NC HIGHWAY 50 STE A
Practice Address - Street 2:
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445-6935
Practice Address - Country:US
Practice Address - Phone:910-777-2732
Practice Address - Fax:910-777-2742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care