Medicine Mart Ltc, LLC
NPI 1174639041 · Long Term Care Pharmacy · Tabor City, NC
Enrolled with Medicare as Part B Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Medicine Mart Ltc, LLC is a Long Term Care Pharmacy organization in Tabor City, NC (NPI 1174639041).
Provider details
- NPI number
- 1174639041
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Sterling Koonce, Managing Agent(910) 653-6805
- License
- 08435 (NC)
Specialties & taxonomies
Suppliers
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
178 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 178 | $30 |
Typical Medicare-allowed amounts for these services range $30–$30 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-08-22
- Last updated
- 2020-07-30
- Certified
- 2020-07-30
Frequently asked questions
- What is Medicine Mart Ltc, LLC's NPI number?
- Medicine Mart Ltc, LLC's National Provider Identifier (NPI) is 1174639041, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Medicine Mart Ltc, LLC?
- Medicine Mart Ltc, LLC is classified in the NPPES registry as Long Term Care Pharmacy (Suppliers).
- Where is Medicine Mart Ltc, LLC located?
- Medicine Mart Ltc, LLC's practice location on file with NPPES is 214 S Main St, Tabor City, NC 28463-1904.
- What is Medicine Mart Ltc, LLC's phone number?
- The practice phone number listed in the NPPES registry for Medicine Mart Ltc, LLC is (910) 653-6804.
- Does Medicine Mart Ltc, LLC accept Medicare?
- Medicine Mart Ltc, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Medicine Mart Ltc, LLC?
- The authorized official listed on Medicine Mart Ltc, LLC's NPPES record is Sterling Koonce, Managing Agent. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Medicine Mart Ltc, LLC's NPI active?
- Yes — Medicine Mart Ltc, LLC's NPI (1174639041) is active in the NPPES registry as of the last update on 2020-07-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.