Provider Demographics
NPI:1457520934
Name:AUDIOLOGY OF THE SANDHILLS, INC
Entity Type:Organization
Organization Name:AUDIOLOGY OF THE SANDHILLS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:VALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-692-6422
Mailing Address - Street 1:1902 N SANDHILLS BLVD
Mailing Address - Street 2:SUITE K
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2382
Mailing Address - Country:US
Mailing Address - Phone:910-692-6422
Mailing Address - Fax:910-692-3484
Practice Address - Street 1:1902 N SANDHILLS BLVD
Practice Address - Street 2:SUITE K
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2382
Practice Address - Country:US
Practice Address - Phone:910-692-6422
Practice Address - Fax:910-692-3484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC872332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404184Medicaid
NC1297COtherBCBSNC
NC252016AMedicare UPIN