Provider Demographics
NPI:1851582613
Name:AFFINITY HOSPITAL LLC
Entity Type:Organization
Organization Name:AFFINITY HOSPITAL LLC
Other - Org Name:TRINITY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED PERSON
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-892-9813
Mailing Address - Street 1:PO BOX 403804
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-3084
Mailing Address - Country:US
Mailing Address - Phone:205-592-1488
Mailing Address - Fax:205-592-1200
Practice Address - Street 1:800 MONTCLAIR RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1908
Practice Address - Country:US
Practice Address - Phone:205-592-1488
Practice Address - Fax:205-592-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPENDINGMedicaid
PENDINGMedicare PIN