Healthcare Provider Details

I. General information

NPI: 1265922314
Provider Name (Legal Business Name): BON SECOURS - RICHMOND COMMUNITY HOSPITAL, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4744 FINLAY ST
RICHMOND VA
23231
US

IV. Provider business mailing address

7229 FOREST AVE STE 112
RICHMOND VA
23226-3765
US

V. Phone/Fax

Practice location:
  • Phone: 804-864-9600
  • Fax: 804-864-9647
Mailing address:
  • Phone: 804-281-0275
  • Fax: 804-521-9344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

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