Provider Demographics
NPI:1477642197
Name:AFFINITY HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:AFFINITY HEALTHCARE SERVICES, INC.
Other - Org Name:AFFINITY HOME HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:205-949-0400
Mailing Address - Street 1:140 OXMOOR BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5986
Mailing Address - Country:US
Mailing Address - Phone:205-949-0400
Mailing Address - Fax:205-949-0405
Practice Address - Street 1:140 OXMOOR BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5986
Practice Address - Country:US
Practice Address - Phone:205-949-0400
Practice Address - Fax:205-949-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11682251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL012-00577OtherBLUE CROSS BLUE SHIELD
ALPIC1624EMedicaid
AL012-00577OtherBLUE CROSS BLUE SHIELD
AL=========OtherTRICARE