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General NPI Number Information
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NPI Number | 1396135331
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Entity Type | Organization
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Legal Business Name | AFFINITY MEDICAL CENTER
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 3143 N ROMAN ST
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6509
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Country | US
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Telephone | 510-633-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 3143 N ROMAN ST
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6509
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Country | US
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Telephone | 510-633-9020
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Fax | 504-241-8894
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. RUBY BEE FAIFEREK
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Credential |
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Telephone | 510-633-9020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | LA
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