Healthcare Provider Details

I. General information

NPI: 1336109107
Provider Name (Legal Business Name): SENTARA HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 COLISEUM DR
HAMPTON VA
23666-5963
US

IV. Provider business mailing address

6015 POPLAR HALL DR SUITE 200
NORFOLK VA
23502-3819
US

V. Phone/Fax

Practice location:
  • Phone: 757-736-2650
  • Fax:
Mailing address:
  • Phone: 757-455-7102
  • Fax: 757-455-7919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH 1894
License Number StateVA

VIII. Authorized Official

Name: MR. ROBERT A. BROERMANN
Title or Position: CFO, SH
Credential:
Phone: 757-455-7020