Provider Demographics
NPI:1942208681
Name:BAPTIST VENTURES-AHP HOMECARE ALLIANCE OF MONTGOMERY
Entity Type:Organization
Organization Name:BAPTIST VENTURES-AHP HOMECARE ALLIANCE OF MONTGOMERY
Other - Org Name:AMERICAN HOMEPATIENT
Other - Org Type:Doing Business As
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:PO BOX 532572
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2572
Mailing Address - Country:US
Mailing Address - Phone:501-671-6813
Mailing Address - Fax:501-671-6801
Practice Address - Street 1:300 TAYLOR RD
Practice Address - Street 2:SUITE 500
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3571
Practice Address - Country:US
Practice Address - Phone:334-613-0303
Practice Address - Fax:334-613-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
AL352332BP3500X
AL900011332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000056788Medicaid
AL1062420001Medicare NSC