Healthcare Provider Details

I. General information

NPI: 1881869931
Provider Name (Legal Business Name): AFFINITY HEALTH ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 WRIGHTSVILLE AVE
WILMINGTON NC
28403-6513
US

IV. Provider business mailing address

204 SOUTH WALKER STREET
BURGAW NC
28425-5215
US

V. Phone/Fax

Practice location:
  • Phone: 910-332-3330
  • Fax: 910-332-3331
Mailing address:
  • Phone: 910-332-3330
  • Fax: 910-332-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005634
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20010111001
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MARK S ARMITAGE
Title or Position: DOCTOR
Credential: MD
Phone: 910-332-3330