Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
Southeastern Anesthesiology Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES T. JOHNSON III (VP CFO)
(910) 671-5090
Entity
Organization
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5290
(910) 671-8512
Mailing address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5290
(910) 671-8512
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H0064
LICENSE
NC
Enumeration date
09/30/2011
Last updated
07/28/2016
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