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General NPI Number Information
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NPI Number | 1730615816
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Entity Type | Organization
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Legal Business Name | SENTARA HEALTHCARE
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 100 IRELAND ST
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City | HAMPTON
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State | VA
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Zip | 23663-2150
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Country | US
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Telephone | 757-727-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 805 LAFAYETTE TER
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City | NEWPORT NEWS
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State | VA
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Zip | 23605-1115
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ATHLETIC TRAINING COORDINATOR
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Name | MOLLIE DELISIO
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Credential |
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Telephone | 401-741-0845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 0126001920
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License Number State | VA
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