Organization
LUMBERTON RADIOLOGICAL ASSOCIATES, PA
Active
Parent organization
LUMBERTON RADIOLOGICAL ASSOCIATES, P.A.
Other names
Wellness Imaging Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUMBERTON RADIOLOGICAL ASSOCIATES, P.A.
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
(910) 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
—
5950357
—
NC
05
—
8902037
—
NC
Enumeration date
08/25/2005
Last updated
07/20/2010
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