Provider Demographics
NPI:1316543937
Name:BON SECOURS MERCY HEALTH FRANKLIN LLC
Entity Type:Organization
Organization Name:BON SECOURS MERCY HEALTH FRANKLIN LLC
Other - Org Name:BON SECOURS SOUTHAMPTON MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SYSTEM DIRECTOR PAYOR ADMINISTRATIO
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:PO BOX 639857
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9857
Mailing Address - Country:US
Mailing Address - Phone:757-569-6339
Mailing Address - Fax:
Practice Address - Street 1:100 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1238
Practice Address - Country:US
Practice Address - Phone:757-569-6339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy