| Generation Clinical Partners Aco, Llc | |
|
723 S Laclede Station Rd Saint Louis MO 63119-4911 | |
| (314) 925-0903 | |
| Not Available |
| Full Name | Generation Clinical Partners Aco, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 723 S Laclede Station Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Walter Lin (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3149250903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Generation Clinical Partners Aco, Llc 10426 Baur Blvd Saint Louis MO 63132-1905 Ph: (314) 925-0903 | Generation Clinical Partners Aco, Llc 723 S Laclede Station Rd Saint Louis MO 63119-4911 Ph: (314) 925-0903 |
| NPI Number | 1740969120 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 07/18/2023 |
| Medicare PECOS PAC ID | 4688038086 |
|---|---|
| Medicare Enrollment ID | O20230919001990 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740969120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Walter Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952481913 PECOS PAC ID: 9931425295 Enrollment ID: I20150317000993 |
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