| Affinia Healthcare | |
|
2220 Lemp Ave Saint Louis MO 63104-2700 | |
| (314) 814-8514 | |
| (314) 814-8542 |
| Full Name | Affinia Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 2220 Lemp Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Janet Voss (CFO) |
| Authorized Official Contact | 3148148571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Affinia Healthcare Po Box 551 Saint Louis MO 63188-0551 Ph: (314) 898-1700 | Affinia Healthcare 2220 Lemp Ave Saint Louis MO 63104-2700 Ph: (314) 814-8514 |
| NPI Number | 1003824293 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 09/12/2023 |
| Medicare PECOS PAC ID | 1052386919 |
|---|---|
| Medicare Enrollment ID | O20051020000343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003824293 | NPI | - | NPPES |
| 507276004 | Medicaid | MO | |
| 26D1046059 | Other | MO | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 507276004 (Missouri) | Primary |
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