Provider Demographics
NPI:1346216447
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 1:1565 SOLUTIONS CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1005
Mailing Address - Country:US
Mailing Address - Phone:319-234-1705
Mailing Address - Fax:319-234-3748
Practice Address - Street 1:1011 1ST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568
Practice Address - Country:US
Practice Address - Phone:715-356-2800
Practice Address - Fax:715-358-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1633 045332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41689000Medicaid
WI416879000Medicaid
WI0210310110Medicare NSC