Southeastern Regional Physician Services
Clinic/Center in Lumberton, NC. Organization (NPI-2).
NPI number1164028361
StatusActive
Last updated in NPPESDec 11, 2020
Details
- NPI
- 1164028361
- Entity type
- Organization (NPI-2)
- Legal business name
- Southeastern Regional Physician Services
- Organization subpart
- No
- Enumeration date
- Dec 11, 2020
- Certification date
- Dec 11, 2020
- Last updated
- Dec 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Southeastern Covid-19 Vaccination Clinic (Doing Business As)
Practice location
2901 N Elm StLumberton, NC 28358-2982
Phone 910-671-5395
Mailing address
2002 N Cedar St Ste BLumberton, NC 28358-3926
Phone 910-272-3048 · Fax 910-671-5538
Authorized official
Ella Hunt
Credentialing
9107373147
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All 29 Clinic/Center providers in Lumberton · All 1,712 providers in Lumberton
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