Provider Demographics
NPI:1811133119
Name:SANDHILLS MEDICAL PHARMACY-2
Entity type:Organization
Organization Name:SANDHILLS MEDICAL PHARMACY-2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NORWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:803-438-5537
Mailing Address - Street 1:425 N SALEM AVE
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4115
Mailing Address - Country:US
Mailing Address - Phone:803-773-8148
Mailing Address - Fax:803-775-5849
Practice Address - Street 1:425 N SALEM AVE
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4115
Practice Address - Country:US
Practice Address - Phone:803-773-8148
Practice Address - Fax:803-775-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215180591OtherNPI
4228210OtherNCPDP