# CENTRA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRA MEDICAL GROUP, LLC
- **Other names:** CMG Anesthesia Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1932685526
- **Legal business name:** CENTRA MEDICAL GROUP, LLC
- **Authorized official:** JOSHUA LARKIN (PAYER CREDENTIALING MANAGER)
- **Authorized official phone:** (434) 200-5047

## Contact information

- **Practice address:** 3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
- **Practice address phone:** (434) 200-5047
- **Mailing address:** 1937 THOMSON DR, LYNCHBURG, VA 24501-1008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/17/2018
- **Last updated:** 07/17/2018