SOUTHEASTERN REGIONAL MEDICAL CENTER NPI 1013975812

NPI Information

NPI: 1013975812
Provider Name: SOUTHEASTERN REGIONAL MEDICAL CENTER

Doing Business As: SOUTHEASTERN RECOVERY ALTERNATIVES

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
4303 LUDGATE ST
LUMBERTON, NC
ZIP 28358
Phone: (910) 671-5000
Get Directions

SOUTHEASTERN REGIONAL MEDICAL CENTER is a clinic center in Lumberton, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SOUTHEASTERN REGIONAL MEDICAL CENTER NPI is 1013975812. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southeastern Recovery Alternatives.

The provider's business location address is:

4303 LUDGATE ST
LUMBERTON, NC
ZIP 28358-460
Phone: (910) 671-5000
Fax: (910) 671-5858

The provider's authorized official is C. Thomas Johnson .
The authorized official title is V. P. Finance and has the following contact phone number (910) 671-5090.

The enumeration date for this NPI number is 5/2/2006 and was last updated on 2/24/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	H0064	NORTH CAROLINA	No
2	1041C0700X	Social Worker	Clinical	H0064	NORTH CAROLINA	No
3	207L00000X	Anesthesiology		H0064	NORTH CAROLINA	No
4	2084P0800X	Psychiatry & Neurology	Psychiatry	HOO64	NORTH CAROLINA	No
5	363A00000X	Physician Assistant		H0064	NORTH CAROLINA	No
6	261Q00000X	Clinic/Center		H0064	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8300343Q	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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