Centennial Medical Group East, Llc

LBN: Centennial Medical Group East, Llc
Centennial Medical Group East, Llc is an health care organization with primary practice located at 1937 W Harvard Ave , Roseburg OR 97471-2720. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Centennial Medical Group East, Llc can be contacted via phone (541) 677-7200, or through Tyree, Kim via phone (541) 229-3332.

Contact Information

Primary practice address
1937 W Harvard Ave Roseburg OR 97471-2720
Phone: (541) 677-7200
Fax: (541) 229-3309
Website:
Map and Directions
Authorized official contact:
Name: Tyree, Kim
Phone: (541) 229-3332

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD12182 Oregon
Ambulatory Health Care Facilities / Rural Health 261QR1300X 38-3896 Oregon

Profile Details

NPI number 1235688805
LBN Legal business name Centennial Medical Group East, Llc
DBA Doing business as
Authorized official Tyree, Kim
Entity Organization
Organization subpart 1 No
Enumeration date Sep 23rd, 2016
Last updated May 1st, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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