Organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Active
Parent organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Other names
BON SECOURS PEDIATRIC NEUROLOGY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Authorized official
STEPHEN QUIRICONI (CFO)
(804) 281-8301
Entity
Organization
Contact information
Practice address
5875 BREMO RD, MOB SOUTH, SUITE 303, RICHMOND, VA 23226-1934
(804) 287-7080
(804) 281-8380
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5462
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
07/26/2010
Last updated
02/13/2019
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