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Organization
AFFINITY REHAB AND MEDICAL SUPPLY, LLC
Active
Organization
AFFINITY REHAB AND MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER MORAN (CHIEF FINANCIAL OFFICER)
(931) 964-0880
Entity
Organization
Contact information
Practice address
4937 HIGHWAY 43 N, SUITE 101, SUMMERTOWN, TN 38483-7052
(931) 964-0880
(931) 964-0886
Mailing address
4937 HIGHWAY 43 N, SUITE 101, SUMMERTOWN, TN 38483-7052
(931) 964-0880
(931) 964-0886
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053538
AMERIGROUP COMMUNITY CARE
TN
05
—
1455157
—
TN
01
—
4153548
BLUECROSS BLUESHIELD
TN
Enumeration date
01/30/2007
Last updated
11/19/2007
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