Healthcare Provider Details

I. General information

NPI: 1194797746
Provider Name (Legal Business Name): AMERICAN HOMEPATIENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 SERVICE CT NE
ROCHESTER MN
55906-8399
US

IV. Provider business mailing address

1565 SOLUTIONS CTR
CHICAGO IL
60677-1005
US

V. Phone/Fax

Practice location:
  • Phone: 507-281-4884
  • Fax: 507-281-0559
Mailing address:
  • Phone: 319-234-1705
  • Fax: 319-234-3748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number3606728
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3606728
License Number StateMN

VIII. Authorized Official

Name: MR. GREG MCCARTHY
Title or Position: COO
Credential:
Phone: 727-530-7700