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DSH340050 S.E. REGL MEDICAL CENTER (Active)
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Main Details
Name
S.E. REGL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH340050
Medicare Provider Number
340050
Additional Details
Current Program Status
Active
Registration Date
10/17/2007
Participating Start Date
7/1/2016
Participating Approval Date
10/17/2007
Last Recertification Date
8/21/2024
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
300 W. 27TH STREET
LUMBERTON, NC 28358-3075
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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6/2/16 Previously participated as an RRC from 1/1/14 through 6/30/16, previously participated as a DSH from 4/1/04 through 12/31/13
06/06/2016
Medicaid # 3400050 is for SRMC Host Provider, Medicaid # 0785659 is for WoodHaven
10/17/2012
April 2025
April 2025
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