# CALABASH MEDICAL CENTER,PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285635219
- **Authorized official:** MRS. TAMMY GORE WARD (INS BILLING/COLLECTIONS)
- **Authorized official phone:** (843) 756-5300

## Contact information

- **Practice address:** 10081 BEACH DR SW, CALABASH, NC 28467-2713
- **Practice address phone:** (800) 579-7971
- **Practice address fax:** (910) 579-2407
- **Mailing address:** 3439 CASEY ST, LORIS, SC 29569-2903
- **Mailing address phone:** (800) 579-7971
- **Mailing address fax:** (910) 579-2407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NC | Yes |

## Other

- **Enumeration date:** 08/01/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 343935A | NC MEDICAID CAROLINA ACCESS | NC |
| 05 | — | 5950176 | — | NC |
| 01 | — | CA9979 | RAILROAD MEDICARE | NC |
| 05 | — | NPA648 | — | SC |
| 01 | — | RCH006 | SC MEDICAID | SC |