Provider Demographics
NPI:1962667287
Name:ION HEALTHCARE
Entity type:Organization
Organization Name:ION HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-794-9290
Mailing Address - Street 1:PO BOX 1947
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-1947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:452 OLD HOOK RD
Practice Address - Street 2:STE 102
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1381
Practice Address - Country:US
Practice Address - Phone:201-261-1119
Practice Address - Fax:201-261-1189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ION HEALTHCARE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-25
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5590210004Medicare NSC