Healthcare Provider Details

I. General information

NPI: 1932554953
Provider Name (Legal Business Name): LOTUS HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 DUMBARTON RD
RICHMOND VA
23228-6014
US

IV. Provider business mailing address

11830 ABERDEEN LANDING LN
MIDLOTHIAN VA
23113-2903
US

V. Phone/Fax

Practice location:
  • Phone: 804-564-2746
  • Fax:
Mailing address:
  • Phone: 804-564-2746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number0101246355
License Number StateVA

VIII. Authorized Official

Name: DR. JAMES EDWARD THOMPSON
Title or Position: CEO
Credential: M.D.
Phone: 804-564-2746