Healthcare Provider Details

I. General information

NPI: 1376945626
Provider Name (Legal Business Name): BON SECOURS ST. FRANCIS MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12340 BERMUDA CROSSROAD LN
CHESTER VA
23831-2352
US

IV. Provider business mailing address

12340 BERMUDA CROSSROAD LN
CHESTER VA
23831-2352
US

V. Phone/Fax

Practice location:
  • Phone: 804-281-0275
  • Fax: 804-521-9344
Mailing address:
  • Phone: 804-281-0275
  • Fax: 804-521-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE O BUTLER
Title or Position: DIRECTOR CORPORATE RESPONSIBILTY
Credential:
Phone: 804-281-0271