Provider Demographics
NPI:1417779620
Name:SOUTHEASTERN REGIOINAL MEDICAL CENTER
Entity type:Organization
Organization Name:SOUTHEASTERN REGIOINAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:LOCKLEAR
Authorized Official - Last Name:CLOTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-671-5000
Mailing Address - Street 1:300 W 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3075
Mailing Address - Country:US
Mailing Address - Phone:910-671-5290
Mailing Address - Fax:910-671-5529
Practice Address - Street 1:300 W 27TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3075
Practice Address - Country:US
Practice Address - Phone:910-671-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty