| Organization Name: | SOUTHEASTERN REGIONAL MEDICAL CENTER |
| NPI Number: | 1013975812 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | C. THOMAS JOHNSON (V. P. FINANCE) |
| Mailing Address: | 4303 Ludgate St Lumberton |
| State: | NC US |
| Postal Code: | 283582460 |
| Phone Number: | 9106715000 |
| Fax Number: | 9106715858 |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 02/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | H0064 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |