MEDICARE: CENTRE CARE NURSING SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1780566455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRE CARE NURSING SERVICES

Provider Business Mailing Address
First Line	:	6737 VOLZ CT
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2113
Country	:	US
Telephone Number	:	334-419-4302
Fax Number	:

Provider Business Practice Location Address
First Line	:	6737 VOLZ CT
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2113
Country	:	US
Telephone Number	:	334-419-4302
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	QUENISHA PETTWAY-LEWIS
Credential	:	RN
Telephone Number	:	334-419-4302

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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