Provider Demographics
NPI:1326812439
Name:AFFINITY PALLIATIVE OF OKLAHOMA LLC
Entity Type:Organization
Organization Name:AFFINITY PALLIATIVE OF OKLAHOMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-499-9977
Mailing Address - Street 1:5627 N CLASSEN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4031
Mailing Address - Country:US
Mailing Address - Phone:405-900-7770
Mailing Address - Fax:405-730-8157
Practice Address - Street 1:5627 N CLASSEN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4031
Practice Address - Country:US
Practice Address - Phone:405-900-7770
Practice Address - Fax:405-730-8157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty