1629038336 NPI number — SENTARA HOSPITALS

Table of content: (NPI 1629038336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629038336 NPI number — SENTARA HOSPITALS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENTARA HOSPITALS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SENTARA VIRGINIA BEACH GENERAL HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629038336
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6015 POPLAR HALL DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502-3819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-455-7102
Provider Business Mailing Address Fax Number:
757-455-7919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1060 FIRST COLONIAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23454-3002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-395-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROERMANN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
CFO, SH
Authorized Official Telephone Number:
757-455-7020

Provider Taxonomy Codes

  • Taxonomy code: 261QR0404X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: H 1897 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 49-0057-0 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000088 . This is a "HEALTHKEEPERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 210052 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 49-0057-0 . This is a "CHARTERED MEDICAID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: VB . This is a "SHM ENTITY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 540683504 . This is a "TRICARE - HILLTOP THER CE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 6560700 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: CV . This is a "COE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 540683504 . This is a "OTHERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 000088 . This is a "TRIGON" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 000088 . This is a "TRIGON HILLTOP THERAPY CE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com