# BON SECOURS MERCY HEALTH PETERSBURG LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BON SECOURS - SOUTHSIDE MEDICAL CENTER, SOUTHSIDE REGIONAL MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720623853
- **Authorized official:** KIMBERLY M RALSTON (SYSTEM DIRECTOR)
- **Authorized official phone:** (419) 996-5119

## Contact information

- **Practice address:** 200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
- **Practice address phone:** (804) 765-5000
- **Mailing address:** PO BOX 639859, CINCINNATI, OH 45263-9859

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 11/13/2019
- **Last updated:** 11/23/2020