Provider Demographics
NPI:1366654576
Name:SENTARA CAREPLEX HOSPITAL
Entity Type:Organization
Organization Name:SENTARA CAREPLEX HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SAFETY OFFICER, SECURITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-736-0910
Mailing Address - Street 1:18485 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:COURTLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23837-2629
Mailing Address - Country:US
Mailing Address - Phone:757-653-7744
Mailing Address - Fax:
Practice Address - Street 1:18485 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:COURTLAND
Practice Address - State:VA
Practice Address - Zip Code:23837-2629
Practice Address - Country:US
Practice Address - Phone:757-653-7744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital