Provider Demographics
NPI:1659367928
Name:AMERICAN HOMEPATIENT, INC.
Entity Type:Organization
Organization Name:AMERICAN HOMEPATIENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-8581
Mailing Address - Street 1:PO BOX 970592
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-0592
Mailing Address - Country:US
Mailing Address - Phone:501-537-2323
Mailing Address - Fax:501-671-6801
Practice Address - Street 1:320 S 10TH ST
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4117
Practice Address - Country:US
Practice Address - Phone:870-239-2101
Practice Address - Fax:870-239-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR57122332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR121046716Medicaid
MO6261404Medicaid
AR121046716Medicaid