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General NPI Number Information
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NPI Number | 1255586277
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Entity Type | Organization
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Legal Business Name | BON SECOURS - RICHMOND COMMUNITY HOSPITAL, INCORPORATED
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 08/10/2018
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Provider Practice Location Address
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Address Line | 4630 S. LABURNUM AVE. SUITE C
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City | RICHMOND
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State | VA
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Zip | 23231
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Country | US
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Telephone | 804-226-4637
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Fax | 804-222-7551
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Provider Business Mailing Address
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Address Line | 4630 S LABURNUM AVE SUITE C
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City | RICHMOND
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State | VA
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Zip | 23231-2424
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Country | US
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Telephone | 804-226-4637
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Fax | 804-222-7551
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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 | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | H1832
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License Number State | VA
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