Organization
SOUTHEASTERN LIFE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY BULLARD (EXECUTIVE DIRECTOR)
(910) 522-0408
Entity
Organization
Contact information
Practice address
3005 N ELM ST, LUMBERTON, NC 28358-2984
(910) 522-0408
Mailing address
PO BOX 3781, PEMBROKE, NC 28372-3781
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
11/13/2024
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