Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
SRMC-Audiology
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. JOHNSON III (CFO)
(910) 671-5090
Entity
Organization
Contact information
Practice address
584 FARRINGDOM ST, LUMBERTON, NC 28358-2615
(910) 671-5014
(910) 608-0269
Mailing address
PO BOX 890860, CHARLOTTE, NC 28289-0860
(910) 671-5000
(910) 608-0269
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3404235
—
NC
05
—
7200273
—
NC
Enumeration date
04/02/2009
Last updated
12/29/2010
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