# SENTARA LIFE CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487644795
- **Authorized official:** DR. MARIA ACHILLEOS PHARMD (CLINICAL PHARMACY SPECIALIST)
- **Authorized official phone:** (757) 252-0988

## Contact information

- **Practice address:** 800 INDEPENDENCE BLVD, SUITE 100, VIRGINIA BEACH, VA 23455-6005
- **Practice address phone:** (757) 252-0975
- **Practice address fax:** (757) 363-6104
- **Mailing address:** 800 INDEPENDENCE BLVD, SUITE 100, VIRGINIA BEACH, VA 23455-6005
- **Mailing address phone:** (757) 252-0975
- **Mailing address fax:** (757) 363-6104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 0201003712 | VA | Yes |
| 3336L0003X | Long Term Care Pharmacy | 07702 | NC | — |

## Other

- **Enumeration date:** 10/27/2005
- **Last updated:** 03/30/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 008519251 | — | VA |
| 05 | — | 0497061 | — | NC |
| 01 | — | 19199 | OPTIMA PROVIDER \# | — |
| 01 | — | 245139 | ANTHEM PROVIDER \# | — |
| 01 | — | 4437379 | AETNA PROVIDER\# | — |
| 01 | — | 4835813 | NABP | — |