CENTENNIAL MEDICAL GROUP WEST LLC NPI 1063710192

NPI Information

NPI: 1063710192
Provider Name: CENTENNIAL MEDICAL GROUP WEST, LLC

Doing Business As: CENTENNIAL SURGICAL ASSISTANTS

Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
2700 NW STEWART PKWY
ROSEBURG, OR
ZIP 97471
Phone: (541) 677-2494
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CENTENNIAL MEDICAL GROUP WEST, LLC is a surgical physician assistant in Roseburg, OR. CENTENNIAL MEDICAL GROUP WEST, LLC NPI is 1063710192. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centennial Surgical Assistants.

The provider's business location address is:

2700 NW STEWART PKWY
ROSEBURG, OR
ZIP 97471-281
Phone: (541) 677-2494
Fax: (541) 677-2294

The provider's authorized official is Rahul Agarwal .
The authorized official title is President and has the following contact phone number (541) 677-2494.

The enumeration date for this NPI number is 3/15/2011 and was last updated on 3/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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