1083686471 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1083686471)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083686471 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:
1083686471
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2008
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:
842 W 76TH ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
DAVENPORT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52806-1366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-388-8270
Provider Business Practice Location Address Fax Number:
563-388-0231
Provider Enumeration Date:
02/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
POWERS
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
615-221-8149

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  5671 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 5671 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 58156 . This is a "BCBS PHARMACY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 58410 . This is a "BCBS OF IA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0256297 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0254946 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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