Provider Demographics
NPI:1184742785
Name:SANDHILLS HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:SANDHILLS HEALTHCARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CEDRICK
Authorized Official - Middle Name:R
Authorized Official - Last Name:SWINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-860-4663
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-0155
Mailing Address - Country:US
Mailing Address - Phone:910-860-4663
Mailing Address - Fax:910-483-7420
Practice Address - Street 1:7233 CLINTON RD
Practice Address - Street 2:
Practice Address - City:STEDMAN
Practice Address - State:NC
Practice Address - Zip Code:28391
Practice Address - Country:US
Practice Address - Phone:910-860-4663
Practice Address - Fax:910-483-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601394Medicaid
NC3418019Medicaid