| Bon Secours St. Mary's Hospital Wound Care Center At Reynolds Crossing | |
|
6900 Forest Ave Suite 115 Richmond VA 23230-1701 | |
| (804) 893-8710 | |
| Not Available |
| Full Name | Bon Secours St. Mary's Hospital Wound Care Center At Reynolds Crossing |
|---|---|
| Speciality | Clinic/center |
| Location | 6900 Forest Ave, Richmond, Virginia |
| Authorized Official Name and Position | George Odell Butler (DIRECTOR OF CORP RESPONSIBILITY) |
| Authorized Official Contact | 8042810271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Secours St. Mary's Hospital Wound Care Center At Reynolds Crossing 6900 Forest Ave Suite 115 Richmond VA 23230-1701 Ph: (804) 893-8710 | Bon Secours St. Mary's Hospital Wound Care Center At Reynolds Crossing 6900 Forest Ave Suite 115 Richmond VA 23230-1701 Ph: (804) 893-8710 |
| NPI Number | 1821350323 |
|---|---|
| Provider Enumeration Date | 06/11/2012 |
| Last Update Date | 10/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821350323 | NPI | - | NPPES |
| 1962464016 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | H1833 (Virginia) | Primary |
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