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General NPI Number Information
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NPI Number | 1124036629
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Entity Type | Organization
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Legal Business Name | BON SECOURS-VIRGINIA HEALTHSOURCE
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 8143 STAPLES MILL RD
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City | RICHMOND
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State | VA
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Zip | 23228
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Country | US
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Telephone | 804-266-2002
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Fax | 804-266-1025
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Provider Business Mailing Address
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Address Line | 7229 FOREST AVE SUITE 208
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City | RICHMOND
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State | VA
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Zip | 23226-3765
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Country | US
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Telephone | 804-281-0271
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Fax | 804-521-9367
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Authorized Official
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Title or Position | DIRECTOR OF CORP RESPONSIBILITY
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Name | GEORGE ODELL BUTLER
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Credential |
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Telephone | 804-281-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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