Southeastern Regional Physician Services

Organization Active NPI Health Maintenance Organization · Lumberton, NC

NPI 1013335009 · NPPES record last updated Apr 7, 2014

Key facts

NPI
1013335009
Entity type
Organization (NPI type 2)
Primary specialty
Health Maintenance Organization 302R00000X
License
H0064 (NC)
Legal business name
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Practice address
103 W 27TH St
Lumberton, NC 28358-3014
Phone
(910) 738-3836
Fax
(910) 738-3959
NPI assigned
Apr 7, 2014
Organization subpart
Yes
Parent organization (as reported)
SOUTHEASTERN REGIONAL MEDICAL CENTER

Authorized official

Name
Fordham B Britt
Title
Director
Phone
(910) 671-5026

Corporate family (same tax ID) 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

National Provider Directory

Tax ID family
Southeastern ASC (38 organizations share this tax ID)
Part of
Southeastern General Ho

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X H0064 NC Yes

Addresses

Primary practice location

103 W 27TH St
Lumberton, NC 28358-3014

Mailing address

2600 N Elm St
Lumberton, NC 28358-3011
Phone (910) 272-3051

Other names

  • Wound Care Professional Services Doing business as

Other providers in Lumberton, NC

All providers in Lumberton, NC · Health Maintenance Organization in North Carolina

Sources for this page

Verify at the official NPI Registry.