1831165620 NPI number — AMERICAN HOMEPATIENT, INC.

Table of content: (NPI 1831165620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831165620 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:
6
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:
1831165620
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 676580
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:
75267-6580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-347-0258
Provider Business Mailing Address Fax Number:
816-525-9862

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 HIGHWAY 332 W
Provider Second Line Business Practice Location Address:
SUITE B-18B
Provider Business Practice Location Address City Name:
LAKE JACKSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77566-4020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-297-1823
Provider Business Practice Location Address Fax Number:
979-297-5822
Provider Enumeration Date:
02/23/2006

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:
727-259-2255

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  0029009 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 0029009 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0114357 01 DM2 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 140042603 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0114357 01 CCP , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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