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General NPI Number Information
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NPI Number | 1265706188
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Entity Type | Organization
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Legal Business Name | BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
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Dates
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Enumeration Date | 02/24/2012
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 6900 FOREST AVE SUITE 110
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City | RICHMOND
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State | VA
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Zip | 23230-1701
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Country | US
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Telephone | 804-893-8715
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Fax | 804-285-1292
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Provider Business Mailing Address
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Address Line | 8580 MAGELLAN PKWY
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City | RICHMOND
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State | VA
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Zip | 23227-1149
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Country | US
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Telephone |
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Fax | 866-449-0896
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Authorized Official
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Title or Position | CFO
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Name | JOSEPH HARDY
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Credential |
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Telephone | 937-478-2932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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