Healthcare Provider Details

I. General information

NPI: 1871569863
Provider Name (Legal Business Name): AMERICAN HOMEPATIENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 COMMERCE ST
LA CROSSE WI
54603-1705
US

IV. Provider business mailing address

1565 SOLUTIONS CTR
CHICAGO IL
60677-1005
US

V. Phone/Fax

Practice location:
  • Phone: 608-779-9900
  • Fax: 608-779-9909
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 Number960 045
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number960 045
License Number StateWI

VIII. Authorized Official

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