Organization
BON SECOURS ST FRANCIS MEDICAL CENTER LLC
Active
Other names
Neruology Clinic - Bon Secours Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M RALSTON (SYSTEM DIRECTOR)
(419) 996-5119
Entity
Organization
Contact information
Practice address
11601 IRON BRIDGE RD, SUITE 207, CHESTER, VA 23831-1466
(804) 285-6880
(804) 706-1585
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101235914
VA
305R00000X
Preferred Provider Organization
0101235914
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09633
MEDICARE GROUP PTAN
VA
Enumeration date
06/10/2009
Last updated
05/05/2022
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