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Organization
SENTARA OBICI AMBULATORY SURGERY, LLC
Active
Organization
SENTARA OBICI AMBULATORY SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA A HERTZLER (ADMINISTRATOR)
(757) 983-2009
Entity
Organization
Contact information
Practice address
2750 GODWIN BLVD, SUFFOLK, VA 23434-8151
(757) 983-2000
Mailing address
2750 GODWIN BLVD., SUFFOLK, VA 23434-8151
(757) 983-2000
(757) 983-2001
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811101439
—
VA
Enumeration date
05/10/2007
Last updated
04/22/2008
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