Provider Demographics
NPI:1164803698
Name:AFFINITY SPECIALTY PHARMACY INC
Entity Type:Organization
Organization Name:AFFINITY SPECIALTY PHARMACY INC
Other - Org Name:AFFINITY SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MELSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-298-3636
Mailing Address - Street 1:1070 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2014
Mailing Address - Country:US
Mailing Address - Phone:828-298-3636
Mailing Address - Fax:828-298-8190
Practice Address - Street 1:1070 TUNNEL RD BLDG 3
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2014
Practice Address - Country:US
Practice Address - Phone:828-298-3636
Practice Address - Fax:828-298-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No3336S0011XSuppliersPharmacySpecialty PharmacyGroup - Multi-Specialty