| Sentara Obici Hospital Psychiatric Unit | |
|
2800 Godwin Blvd Suffolk VA 23434-8038 | |
| (757) 934-4751 | |
| Not Available |
| Full Name | Sentara Obici Hospital Psychiatric Unit |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2800 Godwin Blvd, Suffolk, Virginia |
| Authorized Official Name and Position | Robert A. Broermann (CFO, SH) |
| Authorized Official Contact | 7574557020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sentara Obici Hospital Psychiatric Unit 6015 Poplar Hall Dr Suite 200 Norfolk VA 23502-3819 Ph: (757) 455-7102 | Sentara Obici Hospital Psychiatric Unit 2800 Godwin Blvd Suffolk VA 23434-8038 Ph: (757) 934-4751 |
| NPI Number | 1053475004 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 11/27/2023 |
| Certification Date | 01/03/2020 |
| Medicare PECOS PAC ID | 3274424924 |
|---|---|
| Medicare Enrollment ID | O20130731000574 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053475004 | NPI | - | NPPES |
| 49-0044-8 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H 1869 (Virginia) | Primary |
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