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NPI Code Detail

MEDICARE: AFFINITY HEALTH CENTER

MEDICARE: AFFINITY HEALTH CENTER
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)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396881066
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFINITY HEALTH CENTER
Provider Business Mailing Address
First Line : 455 LAKESHORE PKWY
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-4205
Country : US
Telephone Number : 803-909-6363
Fax Number : 803-909-6364
Provider Business Practice Location Address
First Line : 455 LAKESHORE PKWY
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-4205
Country : US
Telephone Number : 803-909-6363
Fax Number : 803-909-6364
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. HEATHER MCCUTCHEON
Credential :
Telephone Number : 803-909-9720
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/16/2025

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1659666444 — SHUKAIRO M BAKER APRN, PMHNP-BC, LCSW
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1346359569 — SUSAN M COLLINS D.M.D.
Practice Location Address:
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29730-4205
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Directions to “AFFINITY HEALTH CENTER ” Practice Location

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