Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
Southeastern Medical Clinic North Lumberton
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. JOHNSON III (CFO)
(910) 671-5090
Entity
Organization
Contact information
Practice address
725 OAKRIDGE BLVD, SUITE B-2, LUMBERTON, NC 28358-2351
(910) 272-3051
(910) 738-3764
Mailing address
2600 N ELM ST, LUMBERTON, NC 28358-3011
(910) 272-3051
(910) 738-3764
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021M4
BCBSNC
NC
01
—
5911332
CAROLINA ACCESS
NC
05
—
5911332
—
NC
Enumeration date
02/27/2009
Last updated
07/06/2009
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