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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
Other names
Patterson Avenue Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M RALSTON (SYSTEM DIRECTOR)
(419) 996-5119
Entity
Organization
Contact information
Practice address
9600 PATTERSON AVE, RICHMOND, VA 23229-6053
(804) 741-6200
(804) 741-6213
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
11/15/2011
Last updated
10/05/2021
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