Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
Gibson CC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES THOMAS JOHNSON (CHIEF REIMBURSMENT OFFICER)
(910) 671-5083
Entity
Organization
Contact information
Practice address
1200 PINE RUN DR, LUMBERTON, NC 28358-2180
(910) 737-6418
(910) 671-5732
Mailing address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5290
(910) 671-8515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2086X0206X
Surgical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912337684
—
NC
Enumeration date
11/18/2013
Last updated
09/08/2022
Update your record
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