# OPTIMA HEALTH PLAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SENTARA COMMUNITY CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437864709
- **Authorized official:** DORIS PRINCE (DIRECTOR)
- **Authorized official phone:** (175) 798-3547

## Contact information

- **Practice address:** 10800 NUCKOLS RD, GLEN ALLEN, VA 23060-6207
- **Practice address phone:** (804) 613-3940
- **Practice address fax:** (757) 440-3277
- **Mailing address:** 10800 NUCKOLS RD, GLEN ALLEN, VA 23060-6207
- **Mailing address phone:** (804) 613-3940
- **Mailing address fax:** (757) 440-3277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | NULL | — |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 01/20/2023
- **Last updated:** 01/31/2023