# MARY IMMACULATE HOSPITAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MARY IMMACULATE HOSPITAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427064310
- **Authorized official:** KIMBERLY M RALSTON (SYSTEM DIRECTOR PAYOR ADMIN)
- **Authorized official phone:** (419) 996-5119

## Contact information

- **Practice address:** 2 BERNARDINE DR, NEWPORT NEWS, VA 23602-4404
- **Practice address phone:** (757) 886-6500
- **Practice address fax:** (757) 886-6539
- **Mailing address:** PO BOX 639899, CINCINNATI, OH 45263-9899
- **Mailing address phone:** (804) 627-5462
- **Mailing address fax:** (866) 449-0896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | H 1873 | VA | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 08/27/2020