MEDICARE: AFFINITY CARE OF GEORGIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
2	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1154030856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY CARE OF GEORGIA LLC

Provider Business Mailing Address
First Line	:	78 OPAL ST
Second Line	:
City	:	CARTERSVILLE
State	:	GA
Zip	:	30120-2848
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2751 BUFORD HWY NE STE 285
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5488
Country	:	US
Telephone Number	:	510-499-9977
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SAMUEL STERN
Credential	:
Telephone Number	:	510-499-9977

Provider Enumeration Date	:	11/21/2022
Last Update Date	:	06/09/2026

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