Organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Active
Other names
Bon Secours St. Mary's Hospital Sleep Lab
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
5500 MONUMENT AVE, SUITE K, RICHMOND, VA 23226-1452
(804) 673-8160
(804) 673-8165
Mailing address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 285-2011
(804) 285-8327
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
H1833
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4900596
—
VA
Enumeration date
10/20/2009
Last updated
10/24/2018
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