Tabor City Medicine Mart, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

TABOR CITY MEDICINE MART, INC

Practice address

220 S Main St
Tabor City, NC 28463-1904

Phone

(910) 653-4800

Fax

(910) 653-4915

NPI assigned

Oct 26, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sterling Grady Koonce

Title

Owner

Phone

(910) 653-6804

Specialties & licenses 1

Addresses

Tax ID family

Tabor City Medicine Mart2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tabor City Medicine Mart, Inc

  • Community/Retail Pharmacy
  • Tabor City, NC
  • NPI 1912013889
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1801513189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284630580",
            "telephone_number": "910-653-6804",
            "fax_number": "910-653-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S MAIN ST",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284631904",
            "telephone_number": "910-653-4800",
            "fax_number": "910-653-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABOR CITY MEDICINE MART, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "KOONCE",
        "authorized_official_first_name": "STERLING",
        "authorized_official_middle_name": "GRADY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-653-6804"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephens Outreach Center, Inc
• Brittany Renee Sykes, PHARMD
• Tabor City Emergency Services Inc.
• Tabor City Family Medical Clinic, PC
• Tabor City Family Medicine Center, Inc.
• Tabor City Medicine Mart, Inc
• The Asbury Homes, Inc.
• Gayle Marie Thompson, D.C.
• William Hal Thompson, D.C.
• Tara Strickland Todd

• Long Term Care Pharmacy in Tabor City, NC
• Providers in Tabor City, NC by specialty
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.