Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Centra Medical Group Bedford Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
LEWIS ADDISON (SR VP, CFO)
(434) 200-5047
Entity
Organization
Contact information
Practice address
171 W MAIN ST, BEDFORD, VA 24523-1950
(540) 586-7273
Mailing address
2010 ATHERHOLT RD, LYNCHBURG, VA 24501-1106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/17/2013
Last updated
01/30/2014
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