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General NPI Number Information
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NPI Number | 1184297459
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Entity Type | Organization
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Legal Business Name | PRIMELINK MEDICAL CARE
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 2400 OLD BRICK RD STE 62
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City | GLEN ALLEN
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State | VA
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Zip | 23060-5841
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Country | US
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Telephone | 804-223-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 OLD BRICK RD STE 62
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City | GLEN ALLEN
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State | VA
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Zip | 23060-5841
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Country | US
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Telephone | 804-223-6035
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Fax |
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Authorized Official
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Title or Position | CEO & ADMINISTRATOR
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Name | MR. JALIK R BURTON
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Credential | ASSOCIATES/CNA
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Telephone | 804-662-0940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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