Healthcare Provider Details
I. General information
NPI: 1952370983
Provider Name (Legal Business Name): AMERICAN HOMEPATIENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2006
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
819 E ROOSEVELT AVE
GRANTS NM
87020-2115
US
IV. Provider business mailing address
PO BOX 676458
DALLAS TX
75267-6458
US
V. Phone/Fax
- Phone: 505-287-7244
- Fax: 505-287-7010
- Phone: 505-243-3993
- Fax: 505-243-3999
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GREG
MCCARTHY
Title or Position: COO
Credential:
Phone: 727-530-7700