Organization
BON SECOURS AMBULATORY SERVICES LLC
Active
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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