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Organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
Active
Organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
Active
Other names
Laburnum Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CASSIE LOWE (DIRECTOR PAYER ENROLLMENT)
(513) 952-5210
Entity
Organization
Contact information
Practice address
4620 S LABURNUM AVE, RICHMOND, VA 23231
(804) 226-2444
(804) 222-0458
Mailing address
PO BOX 639995, CINCINNATI, OH 45263-9995
(866) 449-0896
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN5711
RAILROAD MEDICARE
VA
Enumeration date
07/08/2006
Last updated
04/24/2024
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