| Bon Secours Lively Medical Center | |
|
36 Lively Oaks Rd Lively VA 22507 | |
| (804) 462-5155 | |
| (804) 462-5922 |
| Full Name | Bon Secours Lively Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 36 Lively Oaks Rd, Lively, Virginia |
| Authorized Official Name and Position | Kimberly Ralston (SYSTEM DIRECTOR) |
| Authorized Official Contact | 4199965119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Secours Lively Medical Center Po Box 639991 Cincinnati OH 45263-9991 Ph: (804) 627-5573 | Bon Secours Lively Medical Center 36 Lively Oaks Rd Lively VA 22507 Ph: (804) 462-5155 |
| NPI Number | 1932699303 |
|---|---|
| Provider Enumeration Date | 05/11/2018 |
| Last Update Date | 09/22/2020 |
| Medicare PECOS PAC ID | 8921060427 |
|---|---|
| Medicare Enrollment ID | O20180725000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932699303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Bon Secours Lively Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 36 Lively Oaks Rd, Lively, VA 22507 Phone: 804-462-5155 Fax: 804-462-5922 | |
Chesapeake Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 36 Lively Oaks Road, Lively, VA 22507 Phone: 804-462-5155 Fax: 804-462-5922 |