1356297337 NPI number — SOUTH LUMBERTON DEVELOPMENT ASSOCIATION INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356297337 NPI number — SOUTH LUMBERTON DEVELOPMENT ASSOCIATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH LUMBERTON DEVELOPMENT ASSOCIATION INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356297337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5961 OLD LUMBERTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28472-5683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-804-6185
Provider Business Mailing Address Fax Number:
910-230-5722

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5961 OLD LUMBERTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28472-5683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-804-6185
Provider Business Practice Location Address Fax Number:
910-230-5722
Provider Enumeration Date:
03/10/2026

Additional Information

Authorized Official

Authorized Official Last Name:
ABDEL AZIZ
Authorized Official First Name:
AHMED
Authorized Official Middle Name:
MALACHI
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
800-804-6185

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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