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General NPI Number Information
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NPI Number | 1679843874
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Entity Type | Organization
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Legal Business Name | CENTURA VENTURES, LLC
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 6011 E WOODMEN RD SUITE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-2605
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Country | US
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Telephone | 719-571-8888
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Fax | 719-571-8889
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Provider Business Mailing Address
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Address Line | PO BOX 801172
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City | KANSAS CITY
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State | MO
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Zip | 64180-1172
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Country | US
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Telephone | 800-953-0104
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Fax | 303-765-6670
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Authorized Official
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Title or Position | VP, AMBULATORY
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Name | MR. DEBRA CARPENTER
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Credential | RN
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Telephone | 303-765-6998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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