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General NPI Number Information
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NPI Number | 1346662343
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Entity Type | Organization
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Legal Business Name | BON SECOURS AMBULATORY SERVICES LLC
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 9851 BROOK RD
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City | GLEN ALLEN
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State | VA
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Zip | 23059-4559
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Country | US
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Telephone | 804-893-8702
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Fax | 804-261-2160
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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 | 804-627-5462
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Fax | 866-449-0896
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Authorized Official
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Title or Position | SYSTEM DIRECTOR
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Name | KIMBERLY RALSON
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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