Organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Active
Other names
Bon Secours Home Infusion
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE ODELL BUTLER (DIRECTOR OF CORP RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
8137 STAPLES MILL RD, RICHMOND, VA 23228
(804) 264-2330
(804) 264-2360
Mailing address
8137 STAPLES MILL RD, RICHMOND, VA 23228-2751
(804) 264-2330
(804) 264-2360
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008512663
—
VA
05
—
009115781
—
VA
01
—
0987250
AETNA HMO
VA
01
—
333692
ANTHEM BCBS OF VA
VA
01
—
5520622
AETNA PPO
VA
Enumeration date
08/04/2006
Last updated
07/27/2018
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