Provider Demographics
NPI:1881931566
Name:WHITE SANDS CORP.
Entity type:Organization
Organization Name:WHITE SANDS CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOMPKINS-SHUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-405-6165
Mailing Address - Street 1:1416 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1923
Mailing Address - Country:US
Mailing Address - Phone:937-322-7385
Mailing Address - Fax:937-398-5189
Practice Address - Street 1:1416 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1923
Practice Address - Country:US
Practice Address - Phone:937-322-7385
Practice Address - Fax:937-398-5189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment