Healthcare Provider Details

I. General information

NPI: 1144292772
Provider Name (Legal Business Name): AFFINITY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 N MAIN ST BOX 2503
LILLINGTON NC
27546-8286
US

IV. Provider business mailing address

1231 N MAIN ST BOX 2503
LILLINGTON NC
27546-8286
US

V. Phone/Fax

Practice location:
  • Phone: 910-814-3660
  • Fax: 910-814-0040
Mailing address:
  • Phone: 910-814-3660
  • Fax: 910-814-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHC1477
License Number StateNC

VIII. Authorized Official

Name: MR. LOYD WALLACE POLLARD
Title or Position: VICE-PRES. CO-OWNER
Credential:
Phone: 910-814-3660