Provider Demographics
NPI:1396347886
Name:LINK PRIMARY CARE LLC
Entity type:Organization
Organization Name:LINK PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:314-740-5820
Mailing Address - Street 1:1034 S BRENTWOOD BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1271
Mailing Address - Country:US
Mailing Address - Phone:314-798-7422
Mailing Address - Fax:314-293-6861
Practice Address - Street 1:1034 S BRENTWOOD BLVD STE 530
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1271
Practice Address - Country:US
Practice Address - Phone:314-798-7422
Practice Address - Fax:314-293-6861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care