Provider Demographics
NPI:1235104100
Name:AMERICAN HOMEPATIENT, INC.
Entity Type:Organization
Organization Name:AMERICAN HOMEPATIENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-530-7700
Mailing Address - Street 1:PO BOX 532697
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2697
Mailing Address - Country:US
Mailing Address - Phone:229-257-0075
Mailing Address - Fax:229-259-0726
Practice Address - Street 1:4105 FORT HENRY DR
Practice Address - Street 2:SUITE 205
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2240
Practice Address - Country:US
Practice Address - Phone:423-247-4032
Practice Address - Fax:423-247-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN425332BP3500X
TN0000001192332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3562204Medicaid
VA9123512Medicaid
VA9123512Medicaid
0210310041Medicare NSC