Provider Demographics
NPI:1497476386
Name:SOUTHEASTERN SERVICES & MORE LLC
Entity Type:Organization
Organization Name:SOUTHEASTERN SERVICES & MORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SKYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-625-5231
Mailing Address - Street 1:816 S MADISON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4670
Mailing Address - Country:US
Mailing Address - Phone:252-414-7154
Mailing Address - Fax:
Practice Address - Street 1:108 MEMORY PLZ # B
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2640
Practice Address - Country:US
Practice Address - Phone:252-414-7154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty