Provider Demographics
NPI:1518374412
Name:AFARR SUPPORTIVE CARE
Entity Type:Organization
Organization Name:AFARR SUPPORTIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AVA
Authorized Official - Middle Name:DOREEN
Authorized Official - Last Name:FARR
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN
Authorized Official - Phone:256-665-8212
Mailing Address - Street 1:1119 BESSEMER RD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-2301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1119 BESSEMER RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-2301
Practice Address - Country:US
Practice Address - Phone:256-665-8212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-13
Last Update Date:2014-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care