Provider Demographics
NPI:1144292772
Name:AFFINITY HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:AFFINITY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRES. CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOYD
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-814-3660
Mailing Address - Street 1:1231 N MAIN ST
Mailing Address - Street 2:BOX 2503
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-8286
Mailing Address - Country:US
Mailing Address - Phone:910-814-3660
Mailing Address - Fax:910-814-0040
Practice Address - Street 1:1231 N MAIN ST
Practice Address - Street 2:BOX 2503
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-8286
Practice Address - Country:US
Practice Address - Phone:910-814-3660
Practice Address - Fax:910-814-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1477374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601116Medicaid
NC3408886Medicaid
NC6600551Medicaid