Healthcare Provider Details

I. General information

NPI: 1255788725
Provider Name (Legal Business Name): AFFINITY HEALTH CARE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2016
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23178 HIGHWAY 421
HYDEN KY
41749-8967
US

IV. Provider business mailing address

PO BOX 952
HAZARD KY
41702-0952
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-1978
  • Fax: 606-672-2417
Mailing address:
  • Phone: 606-672-1978
  • Fax: 606-672-2417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1086
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA CALLAHAN
Title or Position: AO
Credential: PA-C
Phone: 606-672-1978