Organization
CENTENNIAL MEDICAL GROUP LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE MERRILL (DIRECTOR OF BILLING)
(702) 839-1203
Entity
Organization
Contact information
Practice address
7800 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7552
(505) 296-6565
Mailing address
4454 N DECATUR BLVD, LAS VEGAS, NV 89130-5286
(702) 893-1203
(702) 893-1301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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