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General NPI Number Information
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NPI Number | 1841454139
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Entity Type | Organization
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Legal Business Name | BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 7001 FOREST AVE SUITE 100
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City | RICHMOND
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State | VA
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Zip | 23230-1726
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Country | US
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Telephone | 804-288-0808
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Fax | 804-288-8887
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Provider Business Mailing Address
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Address Line | 7001 FOREST AVE SUITE 100
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City | RICHMOND
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State | VA
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Zip | 23230-1726
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Country | US
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Telephone | 804-288-0808
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Fax | 804-288-8887
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Authorized Official
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Title or Position | DIR., CORPORATE RESPONSIBILITY
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Name | MR. GEORGE O. BUTLER
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Credential | MBA
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | VA
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