# BON SECOURS-VIRGINIA HEALTHSOURCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bon Secours MedCare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770730475
- **Authorized official:** GEORGE ODELL BUTLER (DIRECTOR OF CORP RESPONSIBILITY)
- **Authorized official phone:** (804) 281-0271

## Contact information

- **Practice address:** 7001 FOREST AVE, SUITE 103, RICHMOND, VA 23230
- **Practice address phone:** (804) 287-3550
- **Practice address fax:** (804) 281-7840
- **Mailing address:** 7001 FOREST AVE, SUITE 103, RICHMOND, VA 23230-1726
- **Mailing address phone:** (804) 287-3550
- **Mailing address fax:** (804) 281-7840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 0101056520 | VA | — |
| 208D00000X | General Practice Physician | 0101056520 | VA | Yes |

## Other

- **Enumeration date:** 08/25/2008
- **Last updated:** 07/27/2018