Provider Demographics
NPI:1215305271
Name:AFTON MEDICAL SOLUTIONS
Entity type:Organization
Organization Name:AFTON MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-636-9322
Mailing Address - Street 1:90 W AFTON AVE STE G3
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1421
Mailing Address - Country:US
Mailing Address - Phone:877-636-9322
Mailing Address - Fax:
Practice Address - Street 1:90 W AFTON AVE STE G3
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1421
Practice Address - Country:US
Practice Address - Phone:877-636-9322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service