Centennial Medical Group West, Llc

LBN: Centennial Medical Group West, Llc
Centennial Medical Group West, Llc is an health care organization with primary practice located at 2801 Nw Mercy Dr. Ste. 340, Roseburg OR 97471. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Centennial Medical Group West, Llc can be contacted via phone (541) 677-4319, or through Klebe, Douglas via phone (541) 677-3650.

Contact Information

Primary practice address
2801 Nw Mercy Dr. Ste. 340 Roseburg OR 97471
Phone: (541) 677-4319
Fax: (541) 677-2294
Website:
Map and Directions
Authorized official contact:
Name: Klebe, Douglas
Phone: (541) 677-3650

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X

Profile Details

NPI number 1245547744
LBN Legal business name Centennial Medical Group West, Llc
DBA Doing business as
Authorized official Klebe, Douglas
Entity Organization
Organization subpart 1 No
Enumeration date Sep 3rd, 2010
Last updated Mar 7th, 2017 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1245547744 NPPES
Oregon MEDICAID 500626861

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