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BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC NPI 1881795557


NPI Information

NPI: 1881795557
Provider Name: BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC

Doing Business As: CROSSRIDGE PEDIATRICS & INTERNAL MEDICINE

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 49D1062557

Address:
10150 STAPLES MILL RD STE C
GLEN ALLEN, VA
ZIP 23060
Phone: (804) 755-7581
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BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC is a specialist in Glen Allen, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC NPI is 1881795557. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Crossridge Pediatrics & Internal Medicine.

The provider's business location address is:

10150 STAPLES MILL RD STE C
GLEN ALLEN, VA
ZIP 23060-452
Phone: (804) 755-7581
Fax: (804) 755-7586

The provider's authorized official is Wilbur Gay .
The authorized official title is Cfo and has the following contact phone number (864) 561-7672.

The CLIA number assigned to this NPI record is 49D1062557 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2006 and was last updated on 9/3/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0000XInternal MedicineAdolescent MedicineNo
2208000000XPediatricsNo
3174400000XSpecialist0101054649VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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