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General NPI Number Information
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NPI Number | 1497673529
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Entity Type | Organization
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Legal Business Name | VALUECARE GERIATRICS 3 PC
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 623 HAMACHER ST
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City | WATERLOO
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State | IL
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Zip | 62298-1786
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Country | US
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Telephone | 314-925-0903
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Fax |
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Provider Business Mailing Address
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Address Line | 10426 BAUR BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63132-1905
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Country | US
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Telephone | 314-925-0903
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. WALTER LIN
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Credential | MD
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Telephone | 314-925-0903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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