Organization
MARY IMMACULATE HOSPITAL LLC
Active
Other names
MARY IMMACULATE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M RALSTON (SYSTEM DIRECTOR PAYOR ADMIN)
(419) 996-5119
Entity
Organization
Contact information
Practice address
2 BERNARDINE DR, NEWPORT NEWS, VA 23602-4404
(757) 886-6500
(757) 886-6539
Mailing address
PO BOX 639899, CINCINNATI, OH 45263-9899
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H 1873
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4900413
—
VA
Enumeration date
07/31/2006
Last updated
08/27/2020
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