Organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Active
Parent organization
BON SECOURS-VIRGINIA HEALTHSOURCE
Other names
Village Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
BON SECOURS-VIRGINIA HEALTHSOURCE
Authorized official
GEORGE O. BUTLER MBA (DIRECTOR, CORPORATE RESPONSIBILITY)
(804) 281-0271
Entity
Organization
Contact information
Practice address
14366 SOMMERVILLE CT, MIDLOTHIAN, VA 23113
(804) 794-5880
(804) 379-4931
Mailing address
14366 SOMMERVILLE CT, MIDLOTHIAN, VA 23113-6838
(804) 794-5880
(804) 379-4931
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI1391
RAILROAD MEDICARE
VA
Enumeration date
07/09/2006
Last updated
07/27/2018
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