340B Drug Pricing Program Database
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RRC490093-01 SENTARA CAREPLEX HOSPITAL (Terminated)
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Main Details
Name
SENTARA CAREPLEX HOSPITAL
Subdivision Name
Sentara Wound Healing and Hyperbaric Center - Port Warwick I
Type
Rural Referral Center
Rural
Yes
340B ID
RRC490093-01
Medicare Provider Number
490093
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/4/2023
Last Recertification Date
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Sentara CarePlex Hospital
Kapua Conley, Regional President
(757) 736-2655
Primary Contact
Sentara Careplex Hospital
June Javier, Pharmacy Manager
(757) 736-1216
Addresses
Street Address
11803 Jefferson Avenue
Suite 125
Newport News, VA 23606
Billing Address
Sentara Careplex Hospital
6015 Poplar Hall Drive
Norfolk, VA 23502
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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