MEDICARE: KELVIN AFFUL

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1598379448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELVIN AFFUL

Provider Business Mailing Address
First Line	:	138 OLD BAY DR
Second Line	:
City	:	PATASKALA
State	:	OH
Zip	:	43062-7689
Country	:	US
Telephone Number	:	614-670-9127
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 SPRINGFIELD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1431
Country	:	US
Telephone Number	:	937-500-5371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2020
Last Update Date	:	09/08/2020

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Directions to “ KELVIN AFFUL ” Practice Location

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