1891766564 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1891766564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891766564 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:
1891766564
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 532547
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30353-2547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-257-0075
Provider Business Mailing Address Fax Number:
229-259-0726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7170 N 9TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32504-6616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-435-4778
Provider Business Practice Location Address Fax Number:
850-435-8366
Provider Enumeration Date:
01/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCARTHY
Authorized Official First Name:
GREG
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
727-530-7700

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  7464 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 3200517 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 109012701 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 109012700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 109012702 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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