Provider Demographics
NPI:1447207006
Name:AMERICAN HOME MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:AMERICAN HOME MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-524-2463
Mailing Address - Street 1:6560 YOUREE DR
Mailing Address - Street 2:SUITE 1009
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4657
Mailing Address - Country:US
Mailing Address - Phone:318-524-2463
Mailing Address - Fax:318-524-2466
Practice Address - Street 1:6560 YOUREE DR
Practice Address - Street 2:SUITE 1009
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4657
Practice Address - Country:US
Practice Address - Phone:318-524-2463
Practice Address - Fax:318-524-2466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
LA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1428094Medicaid
LA1304360001Medicare NSC