1669444659 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1669444659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669444659 NPI number — AMERICAN HOMEPATIENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HOMEPATIENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669444659
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1565 SOLUTIONS CTR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60677-1005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-234-1705
Provider Business Mailing Address Fax Number:
319-234-3748

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10540 HICKMAN RD
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50325-3711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-252-6268
Provider Business Practice Location Address Fax Number:
515-252-7168
Provider Enumeration Date:
02/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
POWERS
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
615-221-8191

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  1107517 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336H0001X , with the licence number: 1107517 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 33220000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 58408 . This is a "BCBS OF IA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 783818200 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0256776 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0254946 . This is a "WAIVER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 58156 . This is a "BCBS PHARMACY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 51037654802 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".