Organization
CENTRA PACE - FARMVILLE
Active
Parent organization
CENTRA HEALTH
Other names
Centra PACE
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA HEALTH
Authorized official
DOUG DAVENPORT (CFO)
(434) 200-4708
Entity
Organization
Contact information
Practice address
1530 S MAIN ST, FARMVILLE, VA 23901-4512
(434) 315-2890
(434) 392-0333
Mailing address
1530 S MAIN ST, FARMVILLE, VA 23901-4512
(434) 315-2890
(434) 392-0333
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
VA
Other
Enumeration date
09/19/2012
Last updated
03/30/2021
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