MEDICARE: AFFINITY HEALTH CARE, LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1710111968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	2708 S MEDFORD DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-6122
Country	:	US
Telephone Number	:	409-383-1400
Fax Number	:	409-383-1401

Provider Business Practice Location Address
First Line	:	2708 S MEDFORD DR
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75901-6122
Country	:	US
Telephone Number	:	409-383-1400
Fax Number	:	888-659-2676

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BRYAN HARKNESS
Credential	:
Telephone Number	:	936-639-2626

Provider Enumeration Date	:	05/03/2009
Last Update Date	:	05/16/2023

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