NPIMap

Organization Active NPI

Southeastern Regional Medical Center

Doing business as SRMC-Audiology

  • Hearing Aid Equipment
  • Lumberton, NC
National Provider Identifier
1871735019
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Aid EquipmentTaxonomy code 332S00000X
License
H0064 Issued in NC
Legal business name
SOUTHEASTERN REGIONAL MEDICAL CENTER
Doing business as
SRMC-Audiology
Practice address
584 Farringdom St
Lumberton, NC 28358-2615
Phone
(910) 671-5014
Fax
(910) 608-0269
NPI assigned
Apr 2, 2009
Last updated
Dec 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Authorized official

Name
Charles T. Johnson III
Title
Cfo
Phone
(910) 671-5090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X H0064 NC Primary

Addresses

Primary practice location

584 Farringdom St
Lumberton, NC 28358-2615

Mailing address

PO Box 890860
Charlotte, NC 28289-0860
Phone (910) 671-5000

Other identifiers 2

IdentifierTypeStateIssuer
3404235MedicaidNC
7200273MedicaidNC

Other names 1

  • SRMC-Audiology 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

Locations

584 Farringdom St
Lumberton, NC 28358
Phone (910) 671-5014

Practitioners & affiliated clinicians

Practitioners 57

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.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1871735019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890860",
            "telephone_number": "910-671-5000",
            "fax_number": "910-608-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 FARRINGDOM ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582615",
            "telephone_number": "910-671-5014",
            "fax_number": "910-608-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-671-5090",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "NC",
            "license": "H0064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404235",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200273",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRMC-Audiology",
            "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 Dec 29, 2010; 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.