Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
SRMC-Hospice Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. JOHNSON III (CFO)
91067155090
Entity
Organization
Contact information
Practice address
1100 PINE RUN DR, LUMBERTON, NC 28358-2118
(910) 671-1488
(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
315D00000X
Inpatient Hospice
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950730
—
NC
Enumeration date
12/18/2008
Last updated
04/21/2009
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