Organization
ALBARCHA PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM ALBARCHA MD (OWNER)
(618) 355-9970
Entity
Organization
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 233-7750
(618) 355-9972
Mailing address
15134 CLAYTON RD, CHESTERFIELD, MO 63017-7046
(618) 355-9970
(618) 355-9972
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036096687
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096687
—
IL
Enumeration date
01/14/2009
Last updated
08/24/2011
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