SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER PA NPI 1588720072

NPI Information

NPI: 1588720072
Provider Name: SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
101 W 27TH ST
LUMBERTON, NC
ZIP 28358
Phone: (910) 739-0770
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SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA is an ambulatory surgical clinic center in Lumberton, NC. SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA NPI is 1588720072. The provider is registered as an organization entity type.

The provider's business location address is:

101 W 27TH ST
LUMBERTON, NC
ZIP 28358-014
Phone: (910) 739-0770
Fax: (910) 739-4102

The provider's authorized official is Santhosh Augustine .
The authorized official title is President and has the following contact phone number (910) 739-0770.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 1/24/2017.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	138988	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	02BBD	OTHER	NORTH CAROLINA	BCBS
2	2381198	MEDICARE PIN	NORTH CAROLINA
3	3409832	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: 4/28/2024

NPI Synchronization or Removal

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