Provider Demographics
NPI:1912008277
Name:AT HOME MEDICAL, INC.
Entity Type:Organization
Organization Name:AT HOME MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:706-566-9118
Mailing Address - Street 1:324 SAINT LUKES DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7108
Mailing Address - Country:US
Mailing Address - Phone:334-274-0088
Mailing Address - Fax:334-274-0055
Practice Address - Street 1:324 SAINT LUKES DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7108
Practice Address - Country:US
Practice Address - Phone:334-274-0088
Practice Address - Fax:334-274-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51504324OtherBCBS
AL009966240Medicaid