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Organization
BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
Active
Organization
BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
Active
Parent organization
BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
Other names
Pediatric Lung Care - Bon Secours Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
BON SECOURS ST MARY'S HOSPITAL OF RICHMOND LLC
Authorized official
WILBUR GAY (CFO)
(864) 561-7672
Entity
Organization
Contact information
Practice address
5875 BREMO RD STE 104, MOB SOUTH, RICHMOND, VA 23226-1934
(804) 287-7770
(804) 287-7801
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
08/05/2009
Last updated
09/03/2020
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