Provider Demographics
NPI:1831165620
Name:AMERICAN HOMEPATIENT, INC.
Entity type:Organization
Organization Name:AMERICAN HOMEPATIENT, INC.
Other - Org Name:<UNAVAIL>
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:AO
Authorized Official - Phone:727-259-2255
Mailing Address - Street 1:PO BOX 676580
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-6580
Mailing Address - Country:US
Mailing Address - Phone:816-347-0258
Mailing Address - Fax:816-525-9862
Practice Address - Street 1:120 HIGHWAY 332 W
Practice Address - Street 2:SUITE B-18B
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4020
Practice Address - Country:US
Practice Address - Phone:979-297-1823
Practice Address - Fax:979-297-5822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0029009332BP3500X, 332BX2000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0114357 01 DM2Medicaid
TX140042603Medicaid
TX0114357 01 CCPMedicaid
TX140042603Medicaid