Healthcare Provider Details

I. General information

NPI: 1104897826
Provider Name (Legal Business Name): AMERICAN HOMEPATIENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 NORTHSIDE DRIVE SUITE G
VALDOSTA GA
31602-1800
US

IV. Provider business mailing address

PO BOX 532623
ATLANTA GA
30353-2623
US

V. Phone/Fax

Practice location:
  • Phone: 229-244-2467
  • Fax: 229-245-1778
Mailing address:
  • Phone: 229-257-0075
  • Fax: 229-259-0726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberHME1320
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number001198
License Number StateGA

VIII. Authorized Official

Name: MR. FRANK POWERS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 615-221-8149