OrganizationActive
Centennial Medical Group East, LLC
NPI 1235688805 · Rural Health Clinic/Center · Roseburg, OR
Provider details
- NPI number
- 1235688805
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kim Tyree, Coo(541) 229-3332
- License
- MD12182 (OR)
Specialties & taxonomies
Ambulatory Health Care Facilities
Allopathic & Osteopathic Physicians
Practice location
1937 W Harvard Ave
Roseburg, OR 97471-2720
Phone: (541) 677-7200
Fax: (541) 229-3309
Approximate (ZIP-level) locationGet directions
Mailing address
2570 Nw Edenbower Blvd Ste 100
Roseburg, OR 97471-6214
Registry dates
- Enumerated
- 2016-09-23
- Last updated
- 2020-05-01
- Certified
- 2020-05-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.