Provider Demographics
NPI:1336109107
Name:SENTARA HOSPITALS
Entity Type:Organization
Organization Name:SENTARA HOSPITALS
Other - Org Name:SENTARA CAREPLEX HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, SH
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-455-7020
Mailing Address - Street 1:6015 POPLAR HALL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3819
Mailing Address - Country:US
Mailing Address - Phone:757-455-7102
Mailing Address - Fax:757-455-7919
Practice Address - Street 1:3000 COLISEUM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5963
Practice Address - Country:US
Practice Address - Phone:757-736-2650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-25
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0404X
VAH 1894282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000045OtherHEALTHKEEPERS
VAHGOtherSHM ENTITY
VA000045OtherTRIGON
VA49-00093-6OtherCHARTERED MEDICAID
VA232299OtherMAMSI
VA49-0093-6Medicaid
VA540505907OtherOTHERS
VA6560265OtherAETNA
VA540505907OtherOTHERS
VA490093Medicare Oscar/Certification
VA000045OtherTRIGON