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General NPI Number Information
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NPI Number | 1619227691
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Entity Type | Organization
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Legal Business Name | AFFINITY HEALTH MEDICAL SYSTENS
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 3301 GREEN ST SUITE 235
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City | CLAYMONT
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State | DE
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Zip | 19703-2052
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Country | US
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Telephone | 302-439-4951
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Fax | 302-439-4957
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Provider Business Mailing Address
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Address Line | 3301 GREEN ST
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City | CLAYMONT
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State | DE
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Zip | 19703-2052
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Country | US
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Telephone | 302-439-4951
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Fax | 302-439-4957
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAMION WILLIAMS
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Credential |
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Telephone | 302-439-4951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | L10011895
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License Number State | DE
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