Provider Demographics
NPI:1548152754
Name:CENTAURI HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:CENTAURI HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:469-396-1104
Mailing Address - Street 1:1201 W 15TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7252
Mailing Address - Country:US
Mailing Address - Phone:972-360-0911
Mailing Address - Fax:972-360-0911
Practice Address - Street 1:1201 W 15TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7252
Practice Address - Country:US
Practice Address - Phone:972-360-0911
Practice Address - Fax:972-360-0911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTAURI HEALTHCARE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy