Organization
CA GROUP, LLC
Active
Parent organization
CA GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CA GROUP, LLC
Authorized official
JAMES B. DAVIS (EXECUTIVE DIRECTOR)
(618) 257-4644
Entity
Organization
Contact information
Practice address
1245 S MILL ST, NASHVILLE, IL 62263-2004
(618) 257-4644
(618) 257-6946
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
207RC0000X
Cardiovascular Disease Physician
Primary
036058818
IL
Other
Enumeration date
02/14/2013
Last updated
02/21/2013
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