Organization
MARTHA JEFFERSON HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA SUMMERLIN HANCOCK (CFO)
(757) 455-7458
Entity
Organization
Contact information
Practice address
500 MARTHA JEFFERSON DR, CHARLOTTESVILLE, VA 22911-4668
(434) 654-7000
Mailing address
1300 SENTARA PARK, VIRGINIA BEACH, VA 23464-5884
Taxonomy
Speciality
Code
Description
License number
State
261QR0404X
Cardiac Rehabilitation Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
H1872
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000012
BLUE CROSS PROVIDER NUMBE
VA
05
—
004900774
—
VA
Enumeration date
07/11/2005
Last updated
12/11/2025
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