Provider Demographics
NPI:1255688990
Name:AFFINITY BIOTECH INC
Entity Type:Organization
Organization Name:AFFINITY BIOTECH INC
Other - Org Name:AFFINITY BIOTECH, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-768-9130
Mailing Address - Street 1:4100 S. SAGINAW ST.
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2683
Mailing Address - Country:US
Mailing Address - Phone:810-768-9000
Mailing Address - Fax:855-603-5113
Practice Address - Street 1:8312 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4403
Practice Address - Country:US
Practice Address - Phone:718-748-2177
Practice Address - Fax:718-748-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336S0011X
NY0318033336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03500465Medicaid
2139599OtherPK
NY03500465Medicaid