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Organization
MARYVIEW HOSPITAL
Active
Organization
MARYVIEW HOSPITAL
Active
Other names
Bon Secours Home Oxygen
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA G BALLARD MPM (ADMINISTRATOR)
(757) 213-7900
Entity
Organization
Contact information
Practice address
184 BUSINESS PARK DR, SUITE 100, VIRGINIA BEACH, VA 23462-6533
(757) 213-7902
(757) 213-7903
Mailing address
184 BUSINESS PARK DR, SUITE 100, VIRGINIA BEACH, VA 23462-6533
(757) 213-7902
(757) 213-7903
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0207008454
VA
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0206009280
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010113610
—
VA
01
—
171973
ANTHEM
VA
Enumeration date
06/20/2006
Last updated
08/17/2010
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