Provider Demographics
NPI:1003849381
Name:BON SECOURS ST FRANCIS MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:BON SECOURS ST FRANCIS MEDICAL CENTER LLC
Other - Org Name:BON SECOURS RICHMOND OB-GYN AT ST. FRANCIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SYSTEM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-996-5119
Mailing Address - Street 1:8580 MAGELLAN PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:866-449-0896
Practice Address - Street 1:13700 ST FRANCIS BLVD STE 510
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3223
Practice Address - Country:US
Practice Address - Phone:804-423-8462
Practice Address - Fax:804-423-8463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09633OtherMEDICARE PTAN
VADD8379OtherRAILROAD MEDICARE
VAC09633Medicare PIN
VADD8379OtherRAILROAD MEDICARE
VAC58813Medicare UPIN