Provider Demographics
NPI:1447752795
Name:AFFECTRIX WHOLESALE LLC
Entity Type:Organization
Organization Name:AFFECTRIX WHOLESALE LLC
Other - Org Name:AFFECTRIX SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-505-9732
Mailing Address - Street 1:15200 E JEFFERSON AVE STE 101J
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-2055
Mailing Address - Country:US
Mailing Address - Phone:313-528-2199
Mailing Address - Fax:
Practice Address - Street 1:15200 E JEFFERSON AVE STE 101J
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-2055
Practice Address - Country:US
Practice Address - Phone:313-528-2199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies