Healthcare Provider Details

I. General information

NPI: 1184297459
Provider Name (Legal Business Name): PRIMELINK MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 OLD BRICK RD STE 62
GLEN ALLEN VA
23060-5841
US

IV. Provider business mailing address

2400 OLD BRICK RD STE 62
GLEN ALLEN VA
23060-5841
US

V. Phone/Fax

Practice location:
  • Phone: 804-223-6035
  • Fax:
Mailing address:
  • Phone: 804-223-6035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JALIK R BURTON
Title or Position: CEO & ADMINISTRATOR
Credential: ASSOCIATES/CNA
Phone: 804-662-0940