Provider Demographics
NPI:1437502994
Name:BON SECOURS - RICHMOND COMMUNITY HOSPITAL, INCORPORATED
Entity Type:Organization
Organization Name:BON SECOURS - RICHMOND COMMUNITY HOSPITAL, INCORPORATED
Other - Org Name:BON SECOURS PEDIATRIC HEMATOLOGY-ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR CORPORATE RESPONSIBILTY
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:O
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-281-0271
Mailing Address - Street 1:5855 BREMO RD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1930
Mailing Address - Country:US
Mailing Address - Phone:804-281-8182
Mailing Address - Fax:804-281-8263
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 605
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226
Practice Address - Country:US
Practice Address - Phone:804-281-8182
Practice Address - Fax:804-281-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty