1003971631 NPI number — AFFINITY HOME MEDICAL EQUIPMENT INC

Table of content: (NPI 1003971631)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003971631 NPI number — AFFINITY HOME MEDICAL EQUIPMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AFFINITY HOME MEDICAL EQUIPMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003971631
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 130566
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33681-0566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-522-2256
Provider Business Mailing Address Fax Number:
727-527-2005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3511 49TH ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33710-2149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-522-2256
Provider Business Practice Location Address Fax Number:
727-527-2005
Provider Enumeration Date:
12/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHWEITZER
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
727-522-2256

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10621102 . This is a "CITRUS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: R9529 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".