Provider Demographics
NPI:1790552172
Name:CENTRA MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:CENTRA MEDICAL GROUP, LLC
Other - Org Name:CENTRA DANVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-200-6942
Mailing Address - Street 1:PO BOX 829829
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 PARK AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4630
Practice Address - Country:US
Practice Address - Phone:434-857-3600
Practice Address - Fax:434-857-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health