Organization
SOUTHEASTERN REGIOINAL MEDICAL CENTER
Active
Other names
SRMC-Intensivists
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T. JOHNSON III (VP/CFO)
(910) 671-5090
Entity
Organization
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 670-5000
(910) 670-8512
Mailing address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 670-5000
(910) 670-8512
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
PENDING
NC
Enumeration date
07/27/2017
Last updated
11/03/2022
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