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NPI Code Detail

MEDICARE: AFFINIA HEALTHCARE

MEDICARE: AFFINIA HEALTHCARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)5008995962MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
126D0857809OTHERCLIA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093723959
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFINIA HEALTHCARE
Provider Business Mailing Address
First Line : PO BOX 551
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63188-0551
Country : US
Telephone Number : 314-898-1700
Fax Number : 314-814-8542
Provider Business Practice Location Address
First Line : 4414 N FLORISSANT AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-1812
Country : US
Telephone Number : 314-898-1700
Fax Number : 314-898-1688
Authorized Official
Title or Position : CFO
Name : MRS. JANET VOSS
Credential :
Telephone Number : 314-814-8571
Provider Enumeration Date : 08/04/2006
Last Update Date : 09/27/2021

Similar Medicare Providers

1790873743 — VALERIE HIGGINBOTHAM WHNP-BC
Practice Location Address:
4414 N FLORISSANT AVE
SAINT LOUIS, MO
63107-1812
Practice Phone: 314-814-8515
Practice Fax: 314-814-8542
1699819235 — KATHLEEN N. GUERREIN NP
Practice Location Address:
4414 N FLORISSANT AVE
SAINT LOUIS, MO
63107-1812
Practice Phone: 314-898-1700
Practice Fax: 314-814-8542
1083747554 — CLEVELAND EUGENE RAYFORD M.D.
Practice Location Address:
4414 N FLORISSANT AVE
SAINT LOUIS, MO
63107-1812
Practice Phone: 314-898-1720
Practice Fax: 314-898-1688
1336321199 — ROBERT TAXMAN MD
Practice Location Address:
4414 N FLORISSANT AVE
SAINT LOUIS, MO
63107-1812
Practice Phone: 314-898-1700
Practice Fax: 314-814-8542
1114155454 — NAGA NEELIMA NALLAPANENI M.D
Practice Location Address:
4414 NORTH FLORISSANT
ST LOUIS, MO
63107-1812
Practice Phone: 314-898-1700
Practice Fax: 314-814-8542
1144533902 — ANNIECE SPENCER NP-C
Practice Location Address:
4414 N FLORISSANT AVE
SAINT LOUIS, MO
63107-1812
Practice Phone: 314-898-1700
Practice Fax: 314-814-8542

Directions to “AFFINIA HEALTHCARE ” Practice Location

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