Community Intervention Services Agency

LBN: Southeastern Regional Medical Center
Community Intervention Services Agency is an health care organization with primary practice located at 300 W 27Th St , Lumberton NC 28358-3075. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Southeastern Regional Medical Center can be contacted via phone (910) 671-5000, or through Johnson, C. Thomas via phone (910) 671-5090.

Contact Information

Primary practice address
300 W 27Th St Lumberton NC 28358-3075
Phone: (910) 671-5000
Fax: (910) 671-5858
Website:
Map and Directions
Authorized official contact:
Name: Johnson, C. Thomas CPA
Phone: (910) 671-5090

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X H0064 North Carolina

Profile Details

NPI number 1942261714
LBN Legal business name Southeastern Regional Medical Center
DBA Doing business as Community Intervention Services Agency
Authorized official Johnson, C. Thomas CPA
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2006
Last updated Jul 8th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942261714 NPPES
North Carolina MEDICAID 8300343

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