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Organization
MARYVIEW HOSPITAL, LLC
Active
Organization
MARYVIEW HOSPITAL, LLC
Active
Other names
BON SECOURS HOME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M RALSTON (VP REIMBURSEMENT)
(419) 996-5119
Entity
Organization
Contact information
Practice address
7007 HARBOUR VIEW BLVD STE 114, SUFFOLK, VA 23435-3657
(757) 889-4663
(757) 393-4762
Mailing address
PO BOX 639898, CINCINNATI, OH 45263-9898
(513) 952-5002
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001801
ANTHEM BLUE CROSS
VA
01
—
148668900
WORKMANS COMP
VA
01
—
231526
MAMSI, OPTIMUM, GEHA
VA
01
—
26198
SENTARA, OPTIMA
VA
05
—
4972457
—
VA
Enumeration date
06/02/2005
Last updated
09/20/2023
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