Provider Demographics
NPI:1124495643
Name:BON SECOURS AMBULATORY SERVICES - ST. FRANCIS, LLC
Entity type:Organization
Organization Name:BON SECOURS AMBULATORY SERVICES - ST. FRANCIS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-952-5000
Mailing Address - Street 1:3213 N PLEASANTBURG DR STE E2
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-2900
Mailing Address - Country:US
Mailing Address - Phone:513-952-5000
Mailing Address - Fax:
Practice Address - Street 1:1467 WOODRUFF RD STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6505
Practice Address - Country:US
Practice Address - Phone:864-458-8126
Practice Address - Fax:864-458-8129
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. FRANCIS HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-01
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF142OtherMEDICARE
SCGP8691Medicaid