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Organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Active
Organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Active
Other names
Bon Secours 24/7
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY RALSTON (SYSTEM DIRECTOR)
(419) 996-5119
Entity
Organization
Contact information
Practice address
7229 FOREST AVE, SUITE 112, RICHMOND, VA 23226
(804) 281-0275
(804) 521-9344
Mailing address
7229 FOREST AVE, SUITE 112, RICHMOND, VA 23226-3765
(804) 281-0275
(804) 521-9344
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06695
GROUP PTAN
VA
Enumeration date
10/16/2015
Last updated
03/02/2021
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