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Organization
TABOR CITY FAMILY MEDICINE CENTER, INC.
Active
Organization
TABOR CITY FAMILY MEDICINE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM FORD (INS. REP)
(843) 756-5300
Entity
Organization
Contact information
Practice address
909 PIREWAY RD, TABOR CITY, NC 28463-8942
(910) 653-2112
(910) 653-2346
Mailing address
3439 CASEY ST, LORIS, SC 29569-2903
(843) 756-5300
(843) 756-6059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02787
BCBS OF NC
NC
01
—
0363
CIGNA MEDICARE GOV'T SVCS
NC
01
—
1447251103
NPI
NC
05
—
343916A
—
NC
01
—
CA9980
RAILROAD MEDICARE
NC
01
—
E03PA0
MEDICAID FOR SOUTH CAROLINA
SC
Enumeration date
08/03/2005
Last updated
07/21/2022
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