Provider Demographics
NPI:1003832056
Name:AMERICAN HOMECARE SUPPLY MIDATLANTIC
Entity Type:Organization
Organization Name:AMERICAN HOMECARE SUPPLY MIDATLANTIC
Other - Org Name:AIR PRODUCTS HEALTHCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:C
Authorized Official - Last Name:SPROGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-530-0880
Mailing Address - Street 1:480 NORRISTOWN RD
Mailing Address - Street 2:SUITE B & C
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2355
Mailing Address - Country:US
Mailing Address - Phone:484-530-0880
Mailing Address - Fax:484-530-0888
Practice Address - Street 1:480 NORRISTOWN RD
Practice Address - Street 2:SUITE A
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2355
Practice Address - Country:US
Practice Address - Phone:610-260-3150
Practice Address - Fax:610-828-4304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR PRODUCTS & CHEMICALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007735180039Medicaid
PA1281160012Medicare NSC