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CENTRIC OUTPATIENT CATH LAB LLC NPI 1306340997


NPI Information

NPI: 1306340997
Provider Name: CENTRIC OUTPATIENT CATH LAB LLC
Classification: Internal Medicine - 207RI0011X
Entity Type: Organization

Specialization: Interventional Cardiology

CLIA Number: 26D2154376

Address:
2103 SILVA LN
MOBERLY, MO
ZIP 65270
Phone: (660) 616-0022
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CENTRIC OUTPATIENT CATH LAB LLC is an interventional cardiology internal medicine in Moberly, MO. The provider is an area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. CENTRIC OUTPATIENT CATH LAB LLC NPI is 1306340997. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2103 SILVA LN
MOBERLY, MO
ZIP 65270-660
Phone: (660) 616-0022

The provider's authorized official is Sanjeev Dhari Ravipudi .
The authorized official title is Owner and has the following contact phone number (626) 394-6299.

The CLIA number assigned to this NPI record is 26D2154376 - other - clinic/ group practice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2018 and was last updated on 3/20/2018.


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
1207RI0011XInternal MedicineInterventional Cardiology2002015751MISSOURIYes

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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