# CENTRIX MEDICAL MANAGEMENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** C.H.E.S.T
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811269202
- **Authorized official:** MR. ETHAN THEOPHILUS RPSGT (PRESIDENT)
- **Authorized official phone:** (919) 605-2155

## Contact information

- **Practice address:** 1135 KILDAIRE FARM RD, SUITE 200, CARY, NC 27511-7608
- **Practice address phone:** (180) 065-6794
- **Practice address fax:** (187) 722-6707
- **Mailing address:** 1135 KILDAIRE FARM RD, SUITE 200, CARY, NC 27511-7608
- **Mailing address phone:** (180) 065-6794
- **Mailing address fax:** (187) 722-6707

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/01/2012
- **Last updated:** 02/01/2012