=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194797464
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN HOMEPATIENT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1307 N MONROE ST
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32303-5526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-681-0080
-----------------------------------------------------
Fax | 850-681-1022
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 532547
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30353-2547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-681-2888
-----------------------------------------------------
Fax | 850-681-2977
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. VICE PRESIDENT
-----------------------------------------------------
Name | MR. JOHN D. GOUY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-221-8191
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------