LUMBERTON INTERNAL MEDICINE GROUP
NPI 1376647073
Specialist in Lumberton, NC
- Organization
- Specialist
- CLIA Number: 34D0978258
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-19-2026
About LUMBERTON INTERNAL MEDICINE GROUP
This page provides the complete NPI Profile along with additional information for Lumberton Internal Medicine Group, a provider established in Lumberton, North Carolina operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1376647073 assigned on September 2006. The practitioner's primary taxonomy code is 174400000X with license number 9701503 (NC). The provider is registered as an organization and their NPI record was last updated 6 years ago. Lumberton Internal Medicine Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Mac Adolf Montilus Md (President)
- NPI
- 1376647073 Verify this NPI
- Provider Name
- LUMBERTON INTERNAL MEDICINE GROUP
- Entity Type
- Organization
- Location Address
- 4314 LUDGATE ST LUMBERTON, NC 28358
- Location Phone
- (910) 272-8800
- Location Fax
- (910) 272-0508
- Mailing Address
- 4314 LUDGATE ST LUMBERTON, NC 28358
- Mailing Phone
- (910) 272-8800
- Mailing Fax
- (910) 272-0508
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-12-2006
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 9701503
- License State
- NC
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D0978258
- Facility Type
- Physician Office
- Certificate Effective Date
- September 20, 2024
- Certificate Expiration Date
- September 19, 2026
- Laboratory Director
- MAC A. MONTILUS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lumberton Internal Medicine Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376647073, enumerated as an "organization" on September 12, 2006.
The provider is located at 4314 LUDGATE ST LUMBERTON, NC 28358 and the phone number is (910) 272-8800.
Specialist with taxonomy code 174400000X.
