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General NPI Number Information
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NPI Number | 1285635219
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Entity Type | Organization
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Legal Business Name | CALABASH MEDICAL CENTER,PA
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10081 BEACH DR SW
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City | CALABASH
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State | NC
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Zip | 28467-2713
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Country | US
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Telephone | 800-579-7971
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Fax | 910-579-2407
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Provider Business Mailing Address
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Address Line | 3439 CASEY ST
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City | LORIS
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State | SC
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Zip | 29569-2903
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Country | US
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Telephone | 800-579-7971
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Fax | 910-579-2407
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Authorized Official
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Title or Position | INS BILLING/COLLECTIONS
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Name | MRS. TAMMY GORE WARD
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Credential |
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Telephone | 843-756-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NC
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