Healthcare Provider Details

I. General information

NPI: 1124922331
Provider Name (Legal Business Name): BON AIR BOTANICALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8427 HALIDAN DR
NORTH CHESTERFIELD VA
23235-3449
US

IV. Provider business mailing address

8427 HALIDAN DR
NORTH CHESTERFIELD VA
23235-3449
US

V. Phone/Fax

Practice location:
  • Phone: 804-221-0558
  • Fax:
Mailing address:
  • Phone: 804-221-0558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. NORAH CALDWELL HAZELGROVE
Title or Position: FOUNDER/CEO
Credential:
Phone: 804-221-0558