Organization
MARY IMMACULATE HOSPITAL LLC
Active
Parent organization
MARY IMMACULATE HOSPITAL LLC
Other names
Bon Secours Surgical Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY IMMACULATE HOSPITAL LLC
Authorized official
WILBUR GAY (CFO)
(864) 561-7672
Entity
Organization
Contact information
Practice address
12720 MCMANUS BLVD STE 305, NEWPORT NEWS, VA 23602-4414
(757) 947-3170
(757) 947-3180
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/23/2010
Last updated
09/21/2020
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