MEDICARE: SENTARA ENTERPRISES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HCO-171575	VA

General Provider Information

NPI Number	:	1750829164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENTARA ENTERPRISES

Provider Business Mailing Address
First Line	:	535 INDEPENDENCE PKWY
Second Line	:	SUITE 200
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-5176
Country	:	US
Telephone Number	:	757-553-3000
Fax Number	:	757-382-4957

Provider Business Practice Location Address
First Line	:	5360 DISCOVERY PARK BLVD STE 200
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-2860
Country	:	US
Telephone Number	:	757-984-1350
Fax Number	:	757-837-4711

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TERESA L EDWARDS
Credential	:
Telephone Number	:	757-553-3000

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	01/09/2020

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