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Contact Information

CENTENNIAL MEDICAL GROUP
4640 W CRAIG RD
NORTH LAS VEGAS, NV89032-2743
 Phone: 702-839-1203
 Fax: 702-507-0992
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for CENTENNIAL MEDICAL GROUP

NPI # 1598926677
LBN Legal business name CENTENNIAL MEDICAL GROUP
Authorized official CARLA SHERWOOD - (OPERATIONS DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/20/2008
Last updated 06/20/2008 - About 18 years ago
Identifiers
NV Other V103360 MEDICARE P-10
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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