MEDICARE: AMERICAN HOME MEDICAL, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	332BN1400X	Nursing Facility Supplies (DME)	MI
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	MI
3	332BX2000X	Oxygen Equipment & Supplies (DME)	MI

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

General Provider Information

NPI Number	:	1598769309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HOME MEDICAL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 32730
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48232-0730
Country	:	US
Telephone Number	:	586-775-1111
Fax Number	:	586-552-1111

Provider Business Practice Location Address
First Line	:	24912 HARPER AVE
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-1242
Country	:	US
Telephone Number	:	586-775-1111
Fax Number	:	586-552-1111

Authorized Official
Title or Position	:	CEO
Name	:	MISS CYNTHIA LEE ROSE
Credential	:
Telephone Number	:	586-775-1111

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/21/2022

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