Healthcare Provider Details

I. General information

NPI: 1649536764
Provider Name (Legal Business Name): BON SECOURS ST. FRANCIS MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 05/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14051 ST FRANCIS BLVD SUITE 2210
MIDLOTHIAN VA
23114-3201
US

IV. Provider business mailing address

14051 ST FRANCIS BLVD SUITE 2210
MIDLOTHIAN VA
23114-3201
US

V. Phone/Fax

Practice location:
  • Phone: 804-281-0254
  • Fax: 804-521-9344
Mailing address:
  • Phone: 804-281-0254
  • Fax: 804-521-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

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