Organization
PC ASSOCIATES, LLC
Active
Parent organization
PC ASSOCIATES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PC ASSOCIATES, LLC
Authorized official
JAMES B. DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization
Contact information
Practice address
310 N. SEVEN HILLS ROAD, O'FALLON, IL 62269
(618) 624-7127
(618) 622-2578
Mailing address
4500 MEMORIAL DR, MEDICAL AFFAIRS CREDENTIALING DEPARTMENT, BELLEVILLE, IL 62226-5360
(618) 257-4644
(618) 257-6946
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
02/19/2013
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