Healthcare Provider Details

I. General information

NPI: 1083212831
Provider Name (Legal Business Name): AFFINITY CARE OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9349 WATERSTONE BLVD STE 340
CINCINNATI OH
45249-8320
US

IV. Provider business mailing address

9349 WATERSTONE BLVD STE 340
CINCINNATI OH
45249-8326
US

V. Phone/Fax

Practice location:
  • Phone: 513-997-6600
  • Fax: 513-766-7691
Mailing address:
  • Phone: 513-997-6600
  • Fax: 513-766-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL STERN
Title or Position: CEO
Credential:
Phone: 510-499-9977