NPIMap

Organization Active NPI

Southeastern United Care,LLC

  • Home Health Agency
  • Pembroke, NC
National Provider Identifier
1447497243
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC2923 Issued in NC
Legal business name
SOUTHEASTERN UNITED CARE,LLC
Practice address
30 Drakes Branch Drive
Pembroke, NC 28372-7325
Phone
(910) 521-9557
Fax
(910) 521-0077
NPI assigned
Jan 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Authorized official

Name
Mr. Demetrus Locklear
Title
Owner
Phone
(910) 521-9557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC2923 NC Primary

Addresses

Primary practice location

30 Drakes Branch Drive
Pembroke, NC 28372-7325

Mailing address

P.O. Box 159
Pembroke, NC 28372-0159
Phone (910) 521-9557

Other identifiers 1

IdentifierTypeStateIssuer
6601239MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Southeastern United Care LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1447497243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 159",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283720159",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DRAKES BRANCH DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727325",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN UNITED CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-15",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "DEMETRUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-521-9557",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601239",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.