NPIMap

Organization Active NPI

Affinia Healthcare

Doing business as Affinia Healthcare Pharmacy

  • Clinic Pharmacy
  • Saint Louis, MO
National Provider Identifier
1093731945
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
2005037282 Issued in MO
Legal business name
AFFINIA HEALTHCARE
Doing business as
Affinia Healthcare Pharmacy
Practice address
1717 Biddle St
Saint Louis, MO 63106-3454
Phone
(314) 814-8638
Fax
(314) 814-8643
NPI assigned
Jul 14, 2006
Last updated
Sep 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alan Freeman
Title
President and Ceo
Phone
(314) 814-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 2005037282 MO Primary

Addresses

Primary practice location

1717 Biddle St
Saint Louis, MO 63106-3454

Mailing address

2524 Hadley St
Saint Louis, MO 63106-4019
Phone (314) 814-8638

Other identifiers 2

IdentifierTypeStateIssuer
2049150OtherPK
600400709MedicaidMO

Other names 1

  • Affinia Healthcare Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affinia Healthcare21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1093731945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 HADLEY ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631064019",
            "telephone_number": "314-814-8638",
            "fax_number": "314-814-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 BIDDLE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631063454",
            "telephone_number": "314-814-8638",
            "fax_number": "314-814-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINIA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "314-814-8511"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MO",
            "license": "2005037282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049150",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600400709",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affinia Healthcare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.