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NPI Code Detail

MEDICARE: SOUTHEASTERN REGIONAL MEDICAL CENTER

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
1332B00000XDurable Medical Equipment & Medical SuppliesH0064NC

General Provider Information

NPI Number : 1932171378
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEASTERN REGIONAL MEDICAL CENTER
Provider Business Mailing Address
First Line : 1150 PINE RUN DR
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-2118
Country : US
Telephone Number : 910-671-5703
Fax Number :
Provider Business Practice Location Address
First Line : 1150 PINE RUN DR
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-2118
Country : US
Telephone Number : 910-671-5703
Fax Number :
Authorized Official
Title or Position : V. P. FINANCE
Name : MR. C. THOMAS JOHNSON III
Credential : CPA
Telephone Number : 910-671-5090
Provider Enumeration Date : 02/01/2006
Last Update Date : 08/22/2020

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1902877541 — SOUTHEASTERN REGIONAL MEDICAL CENTER
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Directions to “SOUTHEASTERN REGIONAL MEDICAL CENTER ” Practice Location

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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.

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