NPIMap

Organization Active NPI

Southeastern Pharmacy Health Park

Doing business as Southeastern Regional Medical Center

  • Pharmacy
  • Lumberton, NC
National Provider Identifier
1356748057
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
12148 Issued in NC
Legal business name
SOUTHEASTERN PHARMACY HEALTH PARK
Doing business as
Southeastern Regional Medical Center
Practice address
4901 Dawn Dr Ste 1200
Lumberton, NC 28360-8207
Phone
(910) 671-4223
Fax
(910) 671-4224
NPI assigned
Nov 24, 2014
Last updated
Nov 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey Lee Edge, PHARM D
Title
Outpatient Pharmacy Supervisor
Phone
(910) 735-8806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 12148 NC Primary

Addresses

Primary practice location

4901 Dawn Dr Ste 1200
Lumberton, NC 28360-8207

Mailing address

4901 Dawn Dr Ste 1200
Lumberton, NC 28360-8207
Phone (910) 671-4223

Other names 1

  • SOUTHEASTERN REGIONAL MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Reg Med Ctr36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1356748057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 DAWN DR STE 1200",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283608207",
            "telephone_number": "910-671-4223",
            "fax_number": "910-671-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 DAWN DR STE 1200",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283608207",
            "telephone_number": "910-671-4223",
            "fax_number": "910-671-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PHARMACY HEALTH PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "EDGE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OUTPATIENT PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "910-735-8806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NC",
            "license": "12148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHEASTERN REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.