MEDICARE: BON SECOURS ST FRANCIS XAVIER HOSPITAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician

General Provider Information

NPI Number	:	1700601879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BON SECOURS ST FRANCIS XAVIER HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	PO BOX 632509
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-2509
Country	:	US
Telephone Number	:	888-472-0043
Fax Number	:	513-653-4122

Provider Business Practice Location Address
First Line	:	2085 HENRY TECKLENBURG DR STE 320
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-7713
Country	:	US
Telephone Number	:	843-571-6067
Fax Number	:	843-769-4853

Authorized Official
Title or Position	:	VP OPS-ACUTE CARE
Name	:	MATTHEW DESMOND
Credential	:
Telephone Number	:	843-724-2103

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	04/13/2026

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