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General NPI Number Information
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NPI Number | 1134065097
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Entity Type | Organization
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Legal Business Name | BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 11400 N LAKERIDGE PKWY
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City | ASHLAND
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State | VA
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Zip | 23005-8248
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Country | US
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Telephone | 804-388-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 11400 N LAKERIDGE PKWY
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City | ASHLAND
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State | VA
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Zip | 23005-8248
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP REIMBURSEMENT
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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 | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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