Provider Demographics
NPI:1669444659
Name:AMERICAN HOMEPATIENT, INC.
Entity Type:Organization
Organization Name:AMERICAN HOMEPATIENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-8191
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 1:10540 HICKMAN RD
Practice Address - Street 2:SUITE D
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50325-3711
Practice Address - Country:US
Practice Address - Phone:515-252-6268
Practice Address - Fax:515-252-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1107517333600000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33220000Medicaid
IA58408OtherBCBS OF IA
MN783818200Medicaid
IA0256776Medicaid
IA0254946OtherWAIVER
58156OtherBCBS PHARMACY
NE51037654802Medicaid
IL=========010Medicaid
WI33220000Medicaid