1700855616 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1700855616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700855616 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:
1700855616
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 676458
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75267-6458
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-243-3993
Provider Business Mailing Address Fax Number:
505-243-3999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3107 N MAIN ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
ROSWELL
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88201-6677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-622-5612
Provider Business Practice Location Address Fax Number:
505-624-1897
Provider Enumeration Date:
03/14/2006

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1025908 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42910 . This is a "NORTHWOOD NPN" identifier . This identifiers is of the category "OTHER".
  • Identifier: R3837 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4027716 . This is a "BC OF TENN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: NM00T678 . This is a "BCBS OF NM" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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