# SOUTHEASTERN REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Anesthesiology Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003190638
- **Authorized official:** MR. CHARLES T. JOHNSON III (VP CFO)
- **Authorized official phone:** (910) 671-5090

## Contact information

- **Practice address:** 300 W 27TH ST, LUMBERTON, NC 28358-3075
- **Practice address phone:** (910) 671-5290
- **Practice address fax:** (910) 671-8512
- **Mailing address:** 300 W 27TH ST, LUMBERTON, NC 28358-3075
- **Mailing address phone:** (910) 671-5290
- **Mailing address fax:** (910) 671-8512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2011
- **Last updated:** 07/28/2016