340B Drug Pricing Program Database
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DSH340050F S.E. REGL MEDICAL CENTER (Active)
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Main Details
Name
S.E. REGL MEDICAL CENTER
Subdivision Name
GIBSON CANCER CENTER A DEPARTMENT O - SRHH PET at Gibson
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH340050F
Medicare Provider Number
340050
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/3/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/4/2024
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Southeastern Regional Medical Center
Lori Jean Dove, Sr. VP / COO
(910) 671-5477
Primary Contact
Southeastern Regional Medical Center
ERIC LOCKLEAR, DIRECTOR OF PHARMACY
(910) 671-5175
Addresses
Street Address
1200 PINE RUN DR
LUMBERTON, NC 28358-2180
Billing Address
Southeastern Regional Medical Center
PO Box 1408
Lumberton, NC 28359
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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