MEDICARE: ATHOME MEDICAL INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)

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	:	1639124068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHOME MEDICAL INC.

Provider Business Mailing Address
First Line	:	200 AMERICAN RD
Second Line	:
City	:	MORRIS PLAINS
State	:	NJ
Zip	:	07950-2449
Country	:	US
Telephone Number	:	973-538-0485
Fax Number	:	973-538-2703

Provider Business Practice Location Address
First Line	:	315 PHILLIPS AVE
Second Line	:
City	:	SOUTH HACKENSACK
State	:	NJ
Zip	:	07606-1707
Country	:	US
Telephone Number	:	973-538-0483
Fax Number	:	973-538-2703

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DAVID FERGUSON
Credential	:
Telephone Number	:	973-401-6788

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	08/14/2019

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Directions to “ATHOME MEDICAL INC. ” Practice Location

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