Organization
LUMBERTON RADIOLOGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GROVER GODWIN (PRACTICE ADMINISTRATOR)
(910) 738-8222
Entity
Organization
Contact information
Practice address
209 WEST 27TH STREET, LUMBERTON, NC 28358-3016
(910) 738-8222
(910) 671-0846
Mailing address
P.O. BOX 1527, LUMBERTON, NC 28359-1527
(910) 738-8222
(970) 671-0846
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
NC
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02037
BLUE CROSS BLUE SHIELD
NC
05
—
8902037
—
NC
Enumeration date
08/24/2005
Last updated
07/20/2010
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