Provider Demographics
NPI:1427876531
Name:AFFINITY INFUSION RX, LLC
Entity type:Organization
Organization Name:AFFINITY INFUSION RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-771-5517
Mailing Address - Street 1:4616 BROADWAY ST STE B
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-3954
Mailing Address - Country:US
Mailing Address - Phone:346-771-5517
Mailing Address - Fax:
Practice Address - Street 1:4616 BROADWAY ST STE B
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-3954
Practice Address - Country:US
Practice Address - Phone:346-771-5517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy