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General NPI Number Information
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NPI Number | 1558678581
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Entity Type | Organization
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Legal Business Name | AFFINITY DISTRIBUTION, INC
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 919 EARLY BLVD STE B
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City | EARLY
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State | TX
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Zip | 76802-2209
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Country | US
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Telephone | 325-647-1908
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Fax | 800-620-7961
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Provider Business Mailing Address
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Address Line | 5109 82ND ST STE 7-1140
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City | LUBBOCK
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State | TX
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Zip | 79424-3028
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Country | US
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Telephone | 806-771-0335
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. AUBREY HINES
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Credential |
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Telephone | 806-771-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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