Albarcha Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036096687 Issued in IL

Legal business name

ALBARCHA PRIMARY CARE LLC

Practice address

4500 Memorial Dr
Belleville, IL 62226-5360

Phone

(618) 233-7750

Fax

(618) 355-9972

NPI assigned

Jan 14, 2009

Last updated

Aug 24, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bassam Albarcha, MD

Title

Owner

Phone

(618) 355-9970

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1063659902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15134 CLAYTON RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177046",
            "telephone_number": "618-355-9970",
            "fax_number": "618-355-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-233-7750",
            "fax_number": "618-355-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBARCHA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "ALBARCHA",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-355-9970",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036096687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096687",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Renee Akins-Mumphard
• Lubasi Akombelwa, NP
• Mohammed Ismail Al Hamati, MD
• Qamar Mohammad Hussein Al Tinawi, MBBS
• Yahia Al Turk, MD
• Dean Michael Alberts, RPH
• Laeisha Aldridge, LMT
• Hiba Alhalabi, PHARMACIST
• MD S Ali, MD
• All in 4 You Home Health Services, Inc.

• Internal Medicine Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.