Organization
CENTENNIAL PROFESSIONAL THERAPY SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY NURNBERG (DIRECTOR)
(770) 379-1035
Entity
Organization
Contact information
Practice address
303 PERIMETER CTR N, SUITE 510, ATLANTA, GA 30346-3402
(770) 379-1035
(770) 234-5172
Mailing address
303 PERIMETER CTR N, SUITE 510, ATLANTA, GA 30346-3402
(770) 379-1035
(770) 234-5172
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
113146
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002106200
—
ID
05
—
00440076
—
MS
05
—
032746100
—
DC
05
—
076048001
—
TX
05
—
134440716
—
AR
05
—
1960161
—
LA
05
—
200124240A
—
IN
05
—
3563038
—
TN
05
—
5603429
—
MT
05
—
7701861
—
NC
05
—
90274069
—
KY
05
—
972405883A
—
GA
05
—
T4208
—
NM
Enumeration date
06/02/2006
Last updated
03/25/2010
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