Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
WoodHaven Nursing & Alzheimer's Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C. THOMAS JOHNSON III CPA (V. P. FINANCE)
(910) 671-5090
Entity
Organization
Contact information
Practice address
1150 PINE RUN DR, LUMBERTON, NC 28358-2118
(910) 671-5703
Mailing address
1150 PINE RUN DR, LUMBERTON, NC 28358-2118
(910) 671-5703
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3416431
—
NC
05
—
3425054
—
NC
Enumeration date
11/14/2005
Last updated
07/07/2016
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