| Organization Name: | SOUTHEASTERN REGIONAL PHYSICIAN SERVICES |
| NPI Number: | 1013335009 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FORDHAM B BRITT (DIRECTOR) |
| Mailing Address: | 103 W 27th St Lumberton |
| State: | NC US |
| Postal Code: | 283583014 |
| Phone Number: | 9107383836 |
| Fax Number: | 9107383959 |
| NPI Enumeration Date: | 04/07/2014 |
| NPI Last Update Date: | 04/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | H0064 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |