Organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
Active
Parent organization
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
Other names
Bon Secours Behavioral Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
Authorized official
GEORGE O. BUTLER MBA (DIRECTOR, CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
1500 N 28TH ST, 3RD FLOOR, RICHMOND, VA 23223-5332
(804) 371-1675
(804) 225-1764
Mailing address
1500 N 28TH ST, 3RD FLOOR, RICHMOND, VA 23223-5332
(804) 371-1675
(804) 225-1764
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06115
GROUP PTAN
VA
Enumeration date
11/16/2009
Last updated
06/09/2011
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