Organization Active NPI

Southeast Medical Laboratory LLC

  • Clinical Medical Laboratory
  • Whiteville, NC
National Provider Identifier
1366549529
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SOUTHEAST MEDICAL LABORATORY LLC
Practice address
619 Jefferson St
Whiteville, NC 28472-3707
Phone
(910) 642-3697
Fax
(910) 642-5929
NPI assigned
Sep 20, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
John Hodgson, MDNPI 1568450682
Title
Lab Director
Phone
(910) 642-3697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NC Primary

Addresses

Primary practice location

619 Jefferson St
Whiteville, NC 28472-3707

Mailing address

PO Box 790
Whiteville, NC 28472-0790
Phone (910) 641-0400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1366549529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284720790",
            "telephone_number": "910-641-0400",
            "fax_number": "910-642-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723707",
            "telephone_number": "910-642-3697",
            "fax_number": "910-642-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MEDICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HODGSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "910-642-3697",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.