Healthcare Provider Details

I. General information

NPI: 1447236567
Provider Name (Legal Business Name): ATHOME MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 AMERICAN RD
MORRIS PLAINS NJ
07950-2449
US

IV. Provider business mailing address

200 AMERICAN RD
MORRIS PLAINS NJ
07950-2449
US

V. Phone/Fax

Practice location:
  • Phone: 973-538-0485
  • Fax: 973-538-2703
Mailing address:
  • Phone: 973-538-0485
  • Fax: 973-538-2703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0737722
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number0737722
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0737722
License Number StateNJ

VIII. Authorized Official

Name: DAVID FERGUSON
Title or Position: VICE PRESIDENT
Credential:
Phone: 973-401-6788