| Affinia Healthcare | |
|
4414 N Florissant Ave Saint Louis MO 63107-1812 | |
| (314) 898-1700 | |
| (314) 898-1688 |
| Full Name | Affinia Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 4414 N Florissant 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 4414 N Florissant Ave Saint Louis MO 63107-1812 Ph: (314) 898-1700 |
| NPI Number | 1093723959 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 09/27/2021 |
| Medicare PECOS PAC ID | 1052386919 |
|---|---|
| Medicare Enrollment ID | O20051018001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093723959 | NPI | - | NPPES |
| 26D0857809 | Other | CLIA | |
| 500899562 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 5008995962 (Missouri) | Primary |
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