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General NPI Number Information
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NPI Number | 1932285954
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Entity Type | Organization
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Legal Business Name | AFFINITY MEDICAL GROUP INC.
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 395 IRONWOOD DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-2912
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Country | US
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Telephone | 801-262-7700
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Fax | 801-262-7707
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Provider Business Mailing Address
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Address Line | 395 IRONWOOD DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-2912
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Country | US
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Telephone | 801-262-7700
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Fax | 801-262-7707
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID E BOYER
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Credential |
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Telephone | 801-262-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 12026218-002-STC
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License Number State | UT
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