Healthcare Provider Details

I. General information

NPI: 1538317078
Provider Name (Legal Business Name): BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 BREMO RD STE 306
RICHMOND VA
23226-1934
US

IV. Provider business mailing address

8580 MAGELLAN PKWY
RICHMOND VA
23227-1149
US

V. Phone/Fax

Practice location:
  • Phone: 804-287-7322
  • Fax: 804-281-8380
Mailing address:
  • Phone: 804-627-5462
  • Fax: 866-449-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0101048009
License Number StateVA

VIII. Authorized Official

Name: STEPHEN QUIRICONI
Title or Position: CFO
Credential:
Phone: 804-281-8301