Healthcare Provider Details

I. General information

NPI: 1952682213
Provider Name (Legal Business Name): LIEM & LIM ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1781B S MAIN ST
LAURINBURG NC
28352-5407
US

IV. Provider business mailing address

1781B S MAIN ST
LAURINBURG NC
28352-5407
US

V. Phone/Fax

Practice location:
  • Phone: 980-322-5447
  • Fax:
Mailing address:
  • Phone: 980-322-5447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE LIEM GALLOWAY
Title or Position: OWNER
Credential: PHD
Phone: 803-225-4479