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Organization
CENTENNIAL MEDICAL GROUP WEST, LLC
Active
Organization
CENTENNIAL MEDICAL GROUP WEST, LLC
Active
Parent organization
CENTENNIAL MEDICAL GROUP, INC.
Other names
Centennial Surgical Assistants
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTENNIAL MEDICAL GROUP, INC.
Authorized official
RAHUL AGARWAL (PRESIDENT)
(541) 677-2494
Entity
Organization
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471-1281
(541) 677-2494
(541) 677-2294
Mailing address
2801 NW MERCY DR STE 340, ROSEBURG, OR 97471-2348
(541) 677-2494
(541) 677-2294
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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