AFFINIA HEALTHCARE (NPI# 1871069062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871069062 |
Entity Type | Organization |
Organization Name | AFFINIA HEALTHCARE |
Practice Address |
1731 S Broadway Saint Louis MO 63104-4050 |
Mailing Address |
Po Box 551 Saint Louis MO 63188-0551 |
Practice Telephone | 3148148700 |
Practice Fax Number | 3148148542 |
Mailing Telephone | 3148148531 |
Mailing Fax Number | 3148148542 |
Enumeration Date | 2018-10-16 |
Last Update Date | 2018-10-16 |
Authorized Official Name | CORINTHIA DARCEL JAMISON (CREDENTIALING COORDINATOR) |
Authorized Official Telephone | 3148148531 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Lift for Life Academy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023584232 | Affinia Healthcare | Clinic/Center | 5421 Thekla Ave, Saint Louis, MO 63120-2513 | 2018-10-16 |
1003392697 | Affinia Healthcare | Clinic/Center | 2900 Washington Ave, Saint Louis, MO 63103-1306 | 2018-07-17 |
1710395611 | Affinia Healthcare | Clinic/Center | 1908 Ofallon St, Saint Louis, MO 63106-3259 | 2014-07-24 |
1295252088 | Affinia Healthcare | Clinic/Center | 6701 Saint Charles Rock Rd, Saint Louis, MO 63133-1705 | 2017-08-23 |
1407393960 | Affinia Healthcare | Clinic/Center | 6763 Page Ave, Pagedale, MO 63133-1635 | 2017-01-23 |
1346634003 | Affinia Healthcare | Dentist | 1500 Park Avenue, Saint Louis, MO 63104-3024 | 2015-03-20 |
1427221027 | Affinia Healthcare | Clinic/Center | 1430 Olive St, Suite 500, Saint Louis, MO 63103-2303 | 2008-04-04 |
1902816077 | Affinia Healthcare | Clinic/Center | 1717 Biddle St, Saint Louis, MO 63106-3454 | 2006-08-09 |
1093723959 | Affinia Healthcare | Clinic/Center | 4414 N Florissant Ave, Saint Louis, MO 63107-1812 | 2006-08-04 |
1013925890 | Affinia Healthcare | Clinic/Center | 3930 S Broadway, Saint Louis, MO 63118-4626 | 2006-08-04 |
Street Address |
1731 S BROADWAY |
City | SAINT LOUIS |
State | MO |
Zip Code | 63104-4050 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649477241 | Lift for Life Academy | Local Education Agency (LEA) | 1731 S Broadway, Saint Louis, MO 63104-4050 | 2007-06-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
Find all providers in zip 63104 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023584232 | Affinia Healthcare | Clinic/Center | 5421 Thekla Ave, Saint Louis, MO 63120-2513 | 2018-10-16 |
1003392697 | Affinia Healthcare | Clinic/Center | 2900 Washington Ave, Saint Louis, MO 63103-1306 | 2018-07-17 |
1053801282 | Carestl Health | Clinic/Center | 1218 Shepley Dr, Saint Louis, MO 63137 | 2018-05-14 |
1821517319 | Carestl Health | Clinic/Center | 3921 N. Newstead Ave, Saint Louis, MO 63115-2748 | 2017-09-15 |
1417409178 | Carestl Health | Clinic/Center | 4265 Athlone Ave, Saint Louis, MO 63115 | 2016-10-28 |
1124570999 | Carestl Health | Clinic/Center | 4248 Cottage Ave, Saint Louis, MO 63113 | 2016-10-27 |
1710395611 | Affinia Healthcare | Clinic/Center | 1908 Ofallon St, Saint Louis, MO 63106-3259 | 2014-07-24 |
1992117055 | Betty Jean Kerr People's Health Centers | Clinic/Center | 11300 Dunn Rd, Saint Louis, MO 63138-1047 | 2014-05-23 |
1780096941 | Betty Jean Kerr People's Health Centers | Clinic/Center | 6701 Saint Charles Rock Rd, Saint Louis, MO 63133-1705 | 2014-05-22 |
1770828956 | Betty Jean Kerr People's Health Centers | Clinic/Center | 10725 Vorhof Dr, Saint Louis, MO 63136-5731 | 2012-11-29 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63104 |
Please comment or provide details below to improve the information on AFFINIA HEALTHCARE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.