# MARYVIEW HOSPITAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BON SECOURS HOME CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518969617
- **Authorized official:** KIMBERLY M RALSTON (VP REIMBURSEMENT)
- **Authorized official phone:** (419) 996-5119

## Contact information

- **Practice address:** 7007 HARBOUR VIEW BLVD STE 114, SUFFOLK, VA 23435-3657
- **Practice address phone:** (757) 889-4663
- **Practice address fax:** (757) 393-4762
- **Mailing address:** PO BOX 639898, CINCINNATI, OH 45263-9898
- **Mailing address phone:** (513) 952-5002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | VA | Yes |

## Other

- **Enumeration date:** 06/02/2005
- **Last updated:** 09/20/2023

## 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 |