# CENTRA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRA MEDICAL GROUP, LLC
- **Other names:** Centra Health Medical Center-Gretna RHC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1013031368
- **Legal business name:** CENTRA MEDICAL GROUP, LLC
- **Authorized official:** JOSEPH KOONS (MANAGING DIRECTOR REVENUE CYCLE)
- **Authorized official phone:** (434) 200-5047

## Contact information

- **Practice address:** 291 MCBRIDE LN, GRETNA, VA 24557-2773
- **Practice address phone:** (434) 656-1274
- **Mailing address:** 2010 ATHERHOLT RD, LYNCHBURG, VA 24501-1106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 11/17/2015