Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Altavista Medical Center RHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
LEWIS ADDISON (SR VP, CFO)
(434) 200-3656
Entity
Organization
Contact information
Practice address
1280A MAIN ST, ALTAVISTA, VA 24517-1465
(434) 309-1165
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2011
Last updated
11/14/2012
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