Provider Demographics
NPI:1972509180
Name:HAMLET HMA INC
Entity Type:Organization
Organization Name:HAMLET HMA INC
Other - Org Name:SANDHILLS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-205-0400
Mailing Address - Street 1:PO BOX 1227
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-1227
Mailing Address - Country:US
Mailing Address - Phone:910-205-0400
Mailing Address - Fax:910-205-0090
Practice Address - Street 1:222 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-3322
Practice Address - Country:US
Practice Address - Phone:910-205-0400
Practice Address - Fax:910-205-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21758173000000X
NC32811173000000X
NC19375173000000X
NC01535173000000X
NC01463173000000X
NC01487174400000X
NC01169174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Not Answered174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891244TMedicaid
NC8958173Medicaid
NC8923686Medicaid
NC7961852Medicaid
NC89138KAMedicaid
NC89138KXMedicaid
NC8923686Medicaid
NC204165CMedicare ID - Type Unspecified
NC2036311Medicare ID - Type Unspecified
NC7961852Medicaid
NC2279964AMedicare ID - Type Unspecified
NC891244TMedicaid
NCH09235Medicare UPIN
NCC84615Medicare UPIN
NC8958173Medicaid
NC207422CMedicare ID - Type Unspecified
NC2036458Medicare ID - Type Unspecified
NC89138KAMedicaid
NCC85476Medicare UPIN
NCF00908Medicare UPIN