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RRC340050-00 SOUTHEASTERN REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
SOUTHEASTERN REGIONAL MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC340050-00
Medicare Provider Number
340050
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/8/2013
Last Recertification Date
9/8/2016
Termination Date
Termination Reason
10/1/2016
Failure to recertify
Contacts
Authorizing Official
Joann Anderson, President/CEO
(910) 671-5177
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
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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