Healthcare Provider Details

I. General information

NPI: 1801881636
Provider Name (Legal Business Name): SENTARA ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 OLD CHURCH STREET
LOW MOOR VA
24457-9997
US

IV. Provider business mailing address

535 INDEPENDENCE PKWY SUITE 200
CHESAPEAKE VA
23320-5176
US

V. Phone/Fax

Practice location:
  • Phone: 540-863-2140
  • Fax: 540-862-2094
Mailing address:
  • Phone: 757-553-3000
  • Fax: 757-382-4957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNA
License Number StateVA

VIII. Authorized Official

Name: TERESA L EDWARDS
Title or Position: PRESIDENT
Credential:
Phone: 757-553-3000