Organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER INC
Active
Other names
Bon Secours Primary Care Associates - Mechanicsville
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHAN F QUIRICONI (CFO)
(804) 281-8301
Entity
Organization
Contact information
Practice address
7041 LEE PARK RD, MECHANICSVILLE, VA 23111-3682
(804) 746-3505
(804) 730-8038
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06115
GROUP PTAN
VA
Enumeration date
02/10/2016
Last updated
07/10/2019
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