MEDICARE: CENTAURI HEALTHCARE GROUP L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1194674515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTAURI HEALTHCARE GROUP L.L.C.

Provider Business Mailing Address
First Line	:	5999 CUSTER RD STE 110-519
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-9302
Country	:	US
Telephone Number	:	682-597-0672
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 FM 1903 STE 100
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-3659
Country	:	US
Telephone Number	:	430-413-0933
Fax Number	:

Authorized Official
Title or Position	:	C.O.O
Name	:	MRS. LILY PHAM-SMITH
Credential	:
Telephone Number	:	682-597-0672

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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