# SOUTHEASTERN REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SRMC-Hospice Professional Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215173331
- **Authorized official:** CHARLES T. JOHNSON III (CFO)
- **Authorized official phone:** 91067155090

## Contact information

- **Practice address:** 1100 PINE RUN DR, LUMBERTON, NC 28358-2118
- **Practice address phone:** (910) 671-1488
- **Practice address fax:** (910) 738-3764
- **Mailing address:** 2600 N ELM ST, LUMBERTON, NC 28358-3011
- **Mailing address phone:** (910) 272-3051
- **Mailing address fax:** (910) 738-3764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 315D00000X | Inpatient Hospice | H0064 | NC | Yes |

## Other

- **Enumeration date:** 12/18/2008
- **Last updated:** 04/21/2009