Organization
MARY IMMACULATE HOSPITAL LLC
Active
Parent organization
MARY IMMACULATE HOSPITAL LLC
Other names
Bon Secours Mary Immaculate Hospital pro fee
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
2 BERNARDINE DR, NEWPORT NEWS, VA 23602-4404
(757) 398-2208
(757) 398-2004
Mailing address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
08/14/2015
Last updated
09/21/2020
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