| Imdad Long Term Care, Llc | |
|
18 Lochhaven Ln Ballwin MO 63021-8020 | |
| (636) 527-9595 | |
| (636) 527-9595 |
| Full Name | Imdad Long Term Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18 Lochhaven Ln, Ballwin, Missouri |
| Authorized Official Name and Position | Riffat Y Imdad (PRESIDENT) |
| Authorized Official Contact | 3146516129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imdad Long Term Care, Llc 424 W 4th St Waterloo IL 62298-1378 Ph: (618) 939-1193 | Imdad Long Term Care, Llc 18 Lochhaven Ln Ballwin MO 63021-8020 Ph: (636) 527-9595 |
| NPI Number | 1891238077 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 11/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891238077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2000160629 (Missouri) | Primary |
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