MEDICARE: SOUTHEASTERN REGIONAL MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center	H0064	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0185K	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1972595601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEASTERN REGIONAL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	2600 N ELM ST
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-3011
Country	:	US
Telephone Number	:	910-272-3051
Fax Number	:	910-738-3764

Provider Business Practice Location Address
First Line	:	222 S MAIN ST
Second Line	:
City	:	RED SPRINGS
State	:	NC
Zip	:	28377-1622
Country	:	US
Telephone Number	:	910-843-4576
Fax Number	:	910-843-2301

Authorized Official
Title or Position	:	CFO
Name	:	CHARLES THOMAS JOHNSON III
Credential	:
Telephone Number	:	910-671-5090

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	01/27/2009

Similar Medicare Providers

1417191941 — SOUTHEASTERN REGIONAL MEDICAL CENTER
Practice Location Address:

222 S MAIN ST
RED SPRINGS, NC
28377-1622

Practice Phone: 910-865-5955
Practice Fax: 910-738-3764

1205063146 — SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Practice Location Address:

222 S MAIN ST
RED SPRINGS, NC
28377-1622

Practice Phone: 910-843-4576
Practice Fax: 910-738-3764

1477290773 — SARAH JALEEL BRUNELLE
Practice Location Address:

2325 BUTTERMILK XING
CRESCENT SPRINGS, KY
41017-1622

Practice Phone: 859-360-6776
Practice Fax: 859-360-3207

1386671329 — OAKMONT WEST-GREENVILLE SC LLC
Practice Location Address:

600 SULPHUR SPRINGS RD
GREENVILLE, SC
29617-1622

Practice Phone: 864-246-2721
Practice Fax: 864-294-4538

1275562746 — DR. ROBERT M GEVEDON MD
Practice Location Address:

2327 BUTTERMILK XING
CRESCENT SPRINGS, KY
41017-1622

Practice Phone: 859-344-7900
Practice Fax: 859-344-0099

1962513895 — DR. JULIE KAY WESTON D.C.
Practice Location Address:

1060 W IRON SPRINGS RD
PRESCOTT, AZ
86305-1622

Practice Phone: 928-460-5448
Practice Fax: 928-460-5815

Directions to “SOUTHEASTERN REGIONAL MEDICAL CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.