Southeastern Regional Medical Center
Organization Active NPI Rural Health Clinic/Center · Rowland, NC
NPI 1891787503 · NPPES record last updated Jan 24, 2008
Key facts
- NPI
- 1891787503
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- H0064 (NC)
- Legal business name
- SOUTHEASTERN REGIONAL MEDICAL CENTER
- Practice address
- 102 N Bond St
Rowland, NC 28383-9741 - Phone
- (910) 422-3350
- Fax
- (910) 422-3936
- NPI assigned
- Aug 18, 2005
- Organization subpart
- No
Authorized official
- Name
- Charles Thomas Johnson III
- Title
- Vice President Finance
- Phone
- (910) 671-5090
Corporate family (same tax ID) 37
National Provider Directory
- Tax ID family
- Southeastern ASC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | H0064 | NC | Yes |
Addresses
Primary practice location
102 N Bond St
Rowland, NC 28383-9741
Mailing address
2600 N Elm St
Lumberton, NC 28358-3011
Phone (910) 272-3051
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0263J | Other | NC | BLUE CROSS BLUE SHIELD |
| 343417A | Medicaid | NC | |
| 343417C | Medicaid | NC |
Other names
- Rowland Medical Clinic
Other providers in Rowland, NC
- Rowland Rescue Squad Inc
- Kelvin Keith Sampson
- Yvette Hamilton Sanders
- Scotland Memorial Hospital
- David Earl Shelley
- Southeastern Regional Physician Services
- Southeastern Regional Physician Services
- Glenda Spaulding
- Cassandra Steen
- Brittany Nichole Strickland
All providers in Rowland, NC · Rural Health Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.