MEDICARE: AHP HOME CARE ALLIANCE OF TENNESSEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	425	TN
3	332BX2000X	Oxygen Equipment & Supplies (DME)	0000001054	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346215217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHP HOME CARE ALLIANCE OF TENNESSEE

Provider Business Mailing Address
First Line	:	PO BOX 532697
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-2697
Country	:	US
Telephone Number	:	229-257-0075
Fax Number	:	229-259-0726

Provider Business Practice Location Address
First Line	:	111A OLD HICKORY BLVD
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2565
Country	:	US
Telephone Number	:	731-423-3646
Fax Number	:	731-422-5031

Authorized Official
Title or Position	:	COO
Name	:	MR. GREG MCCARTHY
Credential	:
Telephone Number	:	727-530-7700

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/23/2021

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Directions to “AHP HOME CARE ALLIANCE OF TENNESSEE ” Practice Location

Language	Start Address	Practice Location

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