Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
SRMC-Woodhaven Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. JOHNSON III (CFO)
(910) 671-5090
Entity
Organization
Contact information
Practice address
1150 PINE RUN DR, LUMBERTON, NC 28358-2118
(910) 671-5703
(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
314000000X
Skilled Nursing Facility
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950723
—
NC
Enumeration date
12/19/2008
Last updated
04/21/2009
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