1. Home
  2. Directory
  3. North Carolina
  4. Tabor City
  5. Pharmacy
  6. NPI Profile

TABOR CITY MEDICINE MART, INC
NPI 1801513189
Pharmacy - Long Term Care Pharmacy in Tabor City, NC

Active since October 26, 2022CLIA 34D2212070 · Waiver
220 S MAIN ST, TABOR CITY, NC 28463(910) 653-4800(910) 653-4915 Get Directions Write a Review

NPPES record last updated: October 26, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tabor City Medicine Mart, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABOR CITY MEDICINE MART, INC (NPI 1801513189) is a healthcare organization registered as a long term care pharmacy in Tabor City, North Carolina and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through February 1, 2027 and lists Sterling Grady Koonce, Owner, as its authorized official.

NPPES Registry Identity

NPI1801513189
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameTABOR CITY MEDICINE MART, INC
Location Address220 S MAIN STTabor City, NC 28463-1904
Mailing AddressPo Box 580Tabor City, NC 28463-0580 · (910) 653-6804 · Fax (910) 653-4915
Phone(910) 653-4800
Fax(910) 653-4915
Organization SubpartNo
Authorized OfficialSterling Grady KoonceOwner · (910) 653-6804
Enumeration DateOctober 26, 2022
NPPES CertifiedOctober 26, 2022
✔ NPI 1801513189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
220 S MAIN ST, Tabor City, NC 28463
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2212070

Tabor City Medicine Mart · Tabor City, NC
Active · expires Feb 1, 2027
CLIA Number34D2212070
Laboratory TypePharmacy
Certificate Effective DateFebruary 2, 2025
Certificate Expiration DateFebruary 1, 2027
Laboratory DirectorSterling G. Koonce
Laboratory Phone(910) 653-4800
Laboratory LocationTabor City Medicine Mart220 South Main Street, Tabor City, NC 28463
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STERLING GRADY KOONCE RPH
Pharmacist
220 S MAIN ST
TABOR CITY, NC 28463
Columbus County (910) 653-6805
TABOR CITY MEDICINE MART, INC
Pharmacy (Community/Retail Pharmacy)
220 S MAIN ST
TABOR CITY, NC 28463
Columbus County (910) 653-4800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tabor City Medicine Mart, Inc's NPI number?

The NPI number for Tabor City Medicine Mart, Inc is 1801513189. It was assigned to this organization in the NPPES registry on October 26, 2022.

Where is Tabor City Medicine Mart, Inc located?

Tabor City Medicine Mart, Inc is located at 220 S Main St, Tabor City, NC 28463. The listed phone number is (910) 653-4800.

What is Tabor City Medicine Mart, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Tabor City Medicine Mart, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2212070) is associated with this NPI, valid through February 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tabor City Medicine Mart, Inc accept?

Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans, Baylor Scott and White Health Plan and Blue Cross Blue Shield of North Dakota and 12 other insurers list Tabor City Medicine Mart, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tabor City Medicine Mart, Inc was last updated on October 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.