# BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hanover County and Bon Secours Good Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679957948
- **Authorized official:** STEPHAN QUIRICONI (CFO)
- **Authorized official phone:** (804) 281-8301

## Contact information

- **Practice address:** 8200 MEADOWBRIDGE RD STE 301, MECHANICSVILLE, VA 23116-2337
- **Practice address phone:** (804) 442-3750
- **Practice address fax:** (804) 559-8535
- **Mailing address:** 8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
- **Mailing address fax:** (866) 449-0896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2015
- **Last updated:** 07/11/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | C06115 | GROUP PTAN | VA |