Provider Demographics
NPI:1396718219
Name:AMERICAN HOMEPATIENT, INC.
Entity type:Organization
Organization Name:AMERICAN HOMEPATIENT, INC.
Other - Org Name:
Other - Org Type:
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 532600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2600
Mailing Address - Country:US
Mailing Address - Phone:304-645-1058
Mailing Address - Fax:304-645-0024
Practice Address - Street 1:4305 ENTERPRISE DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3246
Practice Address - Country:US
Practice Address - Phone:336-767-7600
Practice Address - Fax:336-767-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2286332BP3500X
NDHC2286332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010076731Medicaid
NC7701907Medicaid
NC7701907Medicaid