Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
Southeatern Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES T. JOHNSON III VP CFO (VP CFO)
(910) 671-5090
Entity
Organization
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
(910) 671-8512
Mailing address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
(910) 671-8512
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H0064
LICENSE
NC
Enumeration date
12/29/2011
Last updated
11/03/2022
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