Provider Demographics
NPI:1750788386
Name:SANDHILLS HOME CARE LLC
Entity type:Organization
Organization Name:SANDHILLS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-690-0582
Mailing Address - Street 1:547 7 LKS N
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9767
Mailing Address - Country:US
Mailing Address - Phone:910-690-0582
Mailing Address - Fax:910-215-8767
Practice Address - Street 1:2701 S OCEAN BLVD
Practice Address - Street 2:UNIT 1534
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-4641
Practice Address - Country:US
Practice Address - Phone:910-690-0582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care