1700883774 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1700883774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700883774 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:
1700883774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160843
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36616-1843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-956-9003
Provider Business Mailing Address Fax Number:
954-956-9004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
578 W CARROLL ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36301-4377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-793-2978
Provider Business Practice Location Address Fax Number:
334-671-1621
Provider Enumeration Date:
07/05/2005

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:
615-221-8149

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  361 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 900375 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000053846 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 027468202 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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