Healthcare Provider Details

I. General information

NPI: 1922594670
Provider Name (Legal Business Name): LION TOURS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 WESTWOOD AVE # 320
RICHMOND VA
23230-4011
US

IV. Provider business mailing address

10454 BRYNMORE DR
NORTH CHESTERFIELD VA
23237-4065
US

V. Phone/Fax

Practice location:
  • Phone: 804-653-3004
  • Fax:
Mailing address:
  • Phone: 804-245-2092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateVA

VIII. Authorized Official

Name: CARL E BERNARD
Title or Position: OWNER
Credential:
Phone: 804-245-2092