Provider Demographics
NPI:1982956678
Name:MARYVIEW HOSPITAL
Entity Type:Organization
Organization Name:MARYVIEW HOSPITAL
Other - Org Name:BON SECOURS ONCOLOGY SPECIALISTS
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:804-627-5462
Mailing Address - Fax:866-449-0896
Practice Address - Street 1:7185 HARBOUR TOWNE PKWY S STE 108
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3796
Practice Address - Country:US
Practice Address - Phone:757-278-2350
Practice Address - Fax:757-451-3138
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARYVIEW HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-05
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty