Organization
BON SECOURS AMBULATORY SERVICES LLC
Active
Other names
Bon Secours Tuckahoe Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE ODELL BUTLER (DIRECTOR CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
1501 MAPLE AVE STE 200, RICHMOND, VA 23226-2553
(804) 285-2300
(804) 527-0250
Mailing address
7229 FOREST AVE STE 112, RICHMOND, VA 23226-3765
(804) 281-0275
(804) 521-9344
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D347
MEDICARE PTAN
VA
Enumeration date
01/12/2018
Last updated
06/16/2018
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