NPI 1780831776

Southeastern Regional Medical Center

Organisation Health Maintenance Organization Lumberton, NC

Practice location

Address: 103 W 27th St, Lumberton, NC 28358-3014
Phone: (910) 738-3836
Fax: (910) 738-3959
Mailing address: 2600 N Elm St, Lumberton, NC 28358-3011

Authorised official

Name: Charles Thomas Johnson
Title: Cfo
Phone: (910) 671-5090

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence H0064 (NC)

Other Health Maintenance Organization providers in North Carolina →

Registry record

NPI: 1780831776
Entity type: Organization
NPI issued: 21 Aug 2008
Record last updated: 25 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.