Healthcare Provider Details

I. General information

NPI: 1659367928
Provider Name (Legal Business Name): AMERICAN HOMEPATIENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S 10TH ST
PARAGOULD AR
72450-4117
US

IV. Provider business mailing address

PO BOX 970592
DALLAS TX
75397-0592
US

V. Phone/Fax

Practice location:
  • Phone: 870-239-2101
  • Fax: 870-239-2102
Mailing address:
  • Phone: 501-537-2323
  • Fax: 501-671-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number57122
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number57122
License Number StateAR

VIII. Authorized Official

Name: MR. ROBERT BENSON
Title or Position: SR. VICE PRESIDENT
Credential:
Phone: 615-221-8581