Provider Demographics
NPI:1154008738
Name:CENTRA HEALTH, INC.
Entity type:Organization
Organization Name:CENTRA HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CULBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-200-3014
Mailing Address - Street 1:1331 OAK LANE
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503
Mailing Address - Country:US
Mailing Address - Phone:434-200-6519
Mailing Address - Fax:434-384-3168
Practice Address - Street 1:1331 OAK LANE
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503
Practice Address - Country:US
Practice Address - Phone:434-200-6519
Practice Address - Fax:434-384-3168
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRA HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201004455OtherPHARMACY LICENSE