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DSH490007H SENTARA NORFOLK GENERAL HOSPITAL (Active)
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Main Details
Name
SENTARA NORFOLK GENERAL HOSPITAL
Subdivision Name
Sentara Ambulatory Care Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490007H
Medicare Provider Number
490007
Outpatient Facility Provider Number
490007
Additional Details
Current Program Status
Active
Registration Date
7/9/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/16/2014
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Sentara Norfolk General Hospital
Christopher P Pierson, Chief Operating Officer
(757) 388-4275
Primary Contact
Sentara Healthcare
JON D HORTON, System Director of Pharmacy
(757) 388-5854
Addresses
Street Address
130 Colley Avenue
Norfolk, VA 23510
Billing Address
Sentara Norfolk General Hospital
1300 Sentara Park
Virginia Beach, VA 23464
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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