# CENTRA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRA MEDICAL GROUP, LLC
- **Other names:** Centra Healthworks Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780416131
- **Legal business name:** CENTRA MEDICAL GROUP, LLC
- **Authorized official:** JOSHUA LARKIN (MANAGER REV CYCLE)
- **Authorized official phone:** (434) 200-5047

## Contact information

- **Practice address:** 125 NATIONWIDE DR FL 2, LYNCHBURG, VA 24502-4272
- **Practice address phone:** (434) 200-6933
- **Mailing address:** 125 NATIONWIDE DR FL 2, LYNCHBURG, VA 24502-4272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2024
- **Last updated:** 08/15/2024