1962475327 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1962475327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962475327 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:
1962475327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1597 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:
217-535-2340
Provider Business Mailing Address Fax Number:
217-535-4140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 HIGHWAY 15 S
Provider Second Line Business Practice Location Address:
STE. 111
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41339-8636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-666-8869
Provider Business Practice Location Address Fax Number:
606-666-4416
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOUY
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
SR, VICE PRESIDENT/ ASSIST. SEC.
Authorized Official Telephone Number:
615-221-8191

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  MG0007 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BX2000X , with the licence number: MG0007 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 90330341 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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