# BON SECOURS-VIRGINIA HEALTHSOURCE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BON SECOURS-VIRGINIA HEALTHSOURCE
- **Other names:** Blackstone Family Practice Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1548293194
- **Legal business name:** BON SECOURS-VIRGINIA HEALTHSOURCE
- **Authorized official:** GEORGE O BUTLER (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (804) 281-0271

## Contact information

- **Practice address:** 213 N MAIN ST, BLACKSTONE, VA 23824
- **Practice address phone:** (434) 292-7261
- **Practice address fax:** (434) 298-0908
- **Mailing address:** 213 N MAIN ST, BLACKSTONE, VA 23824-1425
- **Mailing address phone:** (434) 292-7261
- **Mailing address fax:** (434) 298-0908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 07/27/2018