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Organization

VALUECARE GERIATRICS 1 PC

Active
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Organization

VALUECARE GERIATRICS 1 PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WALTER LIN (CHIEF EXECUTIVE OFFICER)
(314) 925-0903
Entity
Organization

Contact information

Practice address
623 HAMACHER ST, WATERLOO, IL 62298-1786
(314) 925-0903
Mailing address
10426 BAUR BLVD, SAINT LOUIS, MO 63132-1905
(314) 925-0903

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—

Other

Enumeration date
09/08/2026
Last updated
09/08/2026
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