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
1	261QF0400X	Federally Qualified Health Center (FQHC)		MO

General Provider Information

NPI Number	:	1407393960
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	:	6763 PAGE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63133-1635
Country	:	US
Telephone Number	:	314-898-1700
Fax Number	:	314-814-8542

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	ALAN O FREEMAN
Credential	:
Telephone Number	:	314-814-8511

Provider Enumeration Date	:	01/23/2017
Last Update Date	:	09/13/2023

Similar Medicare Providers

1285599480 — ANN MARIE WAY DNP, APRN
Practice Location Address:

6763 PAGE AVE
SAINT LOUIS, MO
63133-1635

Practice Phone: 314-898-1700
Practice Fax:

1821013137 — MS. MARY ELIZABETH DOLAN P.A.
Practice Location Address:

6763 PAGE AVE
SAINT LOUIS, MO
63133-1635

Practice Phone: 314-678-9857
Practice Fax:

1851416697 — MRS. OMOLADUN TIAMIYU M.A
Practice Location Address:

6739 PAGE AVE
SAINT LOUIS, MO
63133-1635

Practice Phone: 314-862-4419
Practice Fax:

1346455490 — DR. JESSICA MICHAJLYSZYN DESPOTOVIC M.D.
Practice Location Address:

6763 PAGE AVE
SAINT LOUIS, MO
63133-1635

Practice Phone: 314-814-8700
Practice Fax: 314-814-8542

1578808531 — TAMRA SUSAN FAUSS M.ED/LPC
Practice Location Address:

6763 PAGE AVE
SAINT LOUIS, MO
63133-1635

Practice Phone: 314-727-1720
Practice Fax:

1811392798 — LEO GORMLEY CRADC
Practice Location Address:

6763 PAGE AVE # MO
SAINT LOUIS, MO
63133-1635

Practice Phone: 314-206-3910
Practice Fax:

Directions to “AFFINIA HEALTHCARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.