Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
Community Intervention Services Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C. THOMAS JOHNSON III CPA (V.P. FINANCE)
(910) 671-5090
Entity
Organization
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
(910) 671-5858
Mailing address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
(910) 671-5858
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300343
—
NC
Enumeration date
03/31/2006
Last updated
07/08/2008
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