# SOUTHEASTERN REGIONAL PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Radiology Associates-LRA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558798348
- **Authorized official:** FORDHAM B BRITT (DIRECTOR)
- **Authorized official phone:** (910) 671-5026

## Contact information

- **Practice address:** 209 W 27TH ST, LUMBERTON, NC 28358-3016
- **Practice address phone:** (910) 738-8222
- **Practice address fax:** (910) 671-8175
- **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 |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | H0064 | NC | Yes |

## Other

- **Enumeration date:** 10/11/2013
- **Last updated:** 10/11/2013