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General NPI Number Information
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NPI Number | 1972544104
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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 | 06/09/2006
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 6207 19TH ST
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City | LUBBOCK
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State | TX
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Zip | 79407-1401
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Country | US
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Telephone | 806-771-0335
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Fax | 806-209-0111
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Provider Business Mailing Address
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Address Line | 5109 82ND ST SUITE 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 | 806-209-0111
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0079200
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License Number State | TX
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