Organization
AFFINIA HEALTHCARE
Active
Other names
Affinia Healthcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN FREEMAN (PRESIDENT)
(314) 814-8511
Entity
Organization
Contact information
Practice address
2220 LEMP AVE, SAINT LOUIS, MO 63104-2700
(314) 814-8570
(314) 814-8590
Mailing address
2524 HADLEY ST, SAINT LOUIS, MO 63106-4019
(314) 814-8570
(314) 814-8590
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
2006004264
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049151
PK
—
05
—
600400717
—
MO
Enumeration date
07/30/2006
Last updated
09/27/2021
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