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General NPI Number Information
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NPI Number | 1174295372
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Entity Type | Organization
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Legal Business Name | INCOMM HEALTHCARE & AFFINITY, INC.
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 250 WILLIAMS ST NW FL 5
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City | ATLANTA
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State | GA
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Zip | 30303-1032
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Country | US
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Telephone | 678-262-4680
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Fax | 650-733-0467
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Provider Business Mailing Address
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Address Line | 250 WILLIAMS ST NW FL 5
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City | ATLANTA
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State | GA
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Zip | 30303-1032
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Country | US
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Telephone | 678-262-4680
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | STEPHEN EUGENE MANTHEY
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Credential |
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Telephone | 678-262-4680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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