1720053697 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1720053697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720053697 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:
1720053697
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 532697
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:
30353-2697
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:
30 COURT SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ERIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37061-4166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-289-4358
Provider Business Practice Location Address Fax Number:
931-289-4500
Provider Enumeration Date:
02/22/2006

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:  425 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 0000001330 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 09274010 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1454154 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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