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General NPI Number Information
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NPI Number | 1124772470
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Entity Type | Organization
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Legal Business Name | BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 5801 BREMO RD
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City | RICHMOND
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State | VA
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Zip | 23226-1907
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Country | US
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Telephone | 804-221-7174
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 631683
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City | CINCINNATI
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State | OH
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Zip | 45263-1683
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Country | US
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Telephone | 419-251-8515
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Fax |
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Authorized Official
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Title or Position | SYSTEM DIRECTOR - PAYOR ADMIN
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Name | KIMBERLY M RALSTON
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Credential |
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Telephone | 419-996-5119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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