Medicine Mart Ltc, Llc

LBN: Medicine Mart Ltc, Llc
Medicine Mart Ltc, Llc is an health care organization with primary practice located at 214 S Main St , Tabor City NC 28463-1904. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Long Term Care Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Medicine Mart Ltc, Llc can be contacted via phone (910) 653-6804, or through Koonce, Sterling G via phone (910) 653-6805.

Contact Information

Primary practice address
214 S Main St Tabor City NC 28463-1904
Phone: (910) 653-6804
Fax: (910) 653-4915
Website:
Map and Directions
Authorized official contact:
Name: Koonce, Sterling G RPH
Phone: (910) 653-6805

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X 084535 North Carolina
Suppliers / Specialty Pharmacy 3336S0011X 08435 North Carolina

Profile Details

NPI number 1174639041
LBN Legal business name Medicine Mart Ltc, Llc
DBA Doing business as
Authorized official Koonce, Sterling G RPH
Entity Organization
Organization subpart 1 No
Enumeration date Aug 22nd, 2006
Last updated Jul 30th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174639041 NPPES
North Carolina MEDICAID 0245845

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