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General NPI Number Information
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NPI Number | 1730596933
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Entity Type | Organization
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Legal Business Name | CENTRA
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Dates
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Enumeration Date | 07/20/2014
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Last Update Date | 07/20/2014
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Provider Practice Location Address
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Address Line | 800 OAK ST
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City | FARMVILLE
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State | VA
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Zip | 23901-1199
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Country | US
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Telephone | 434-315-2420
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Fax | 434-392-4067
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Provider Business Mailing Address
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Address Line | 800 OAK ST
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City | FARMVILLE
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State | VA
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Zip | 23901-1199
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Country | US
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Telephone | 434-315-2420
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Fax | 434-392-4067
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Authorized Official
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Title or Position | CLINICIAN II
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Name | REGINA L CALLAGHAN
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Credential |
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Telephone | 434-315-2420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 0001225937
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License Number State | VA
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