Healthcare Provider Details
I. General information
NPI: 1962402248
Provider Name (Legal Business Name): AMERICAN HOMEPATIENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2005
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1432 E WASHINGTON AVE
JONESBORO AR
72401-3259
US
IV. Provider business mailing address
PO BOX 676499
DALLAS TX
75267-6499
US
V. Phone/Fax
- Phone: 870-972-1580
- Fax: 870-972-1582
- Phone: 501-537-2323
- Fax: 501-671-6801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | G00195 |
| License Number State | AR |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | G00195 |
| License Number State | AR |
VIII. Authorized Official
Name: MR.
GREG
MCCARTHY
Title or Position: COO
Credential:
Phone: 727-530-7700