Provider Demographics
NPI:1104034198
Name:APRIA HEALTHCARE
Entity Type:Organization
Organization Name:APRIA HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-369-2000
Mailing Address - Street 1:18120 AMMI TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-1107
Mailing Address - Country:US
Mailing Address - Phone:832-601-7000
Mailing Address - Fax:281-821-4814
Practice Address - Street 1:5912 U S HIGHWAY 49
Practice Address - Street 2:#C-1A
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7569
Practice Address - Country:US
Practice Address - Phone:601-544-0366
Practice Address - Fax:601-544-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440351Medicaid