Provider Demographics
NPI:1952370983
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 676458
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-6458
Mailing Address - Country:US
Mailing Address - Phone:505-243-3993
Mailing Address - Fax:505-243-3999
Practice Address - Street 1:819 E ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2115
Practice Address - Country:US
Practice Address - Phone:505-287-7244
Practice Address - Fax:505-287-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
1025906OtherUNITED HEALTHCARE
52907OtherNORTHWOOD NPN
NMR4079Medicaid
NMNM00T15XOtherBCBS OF NM
040045499OtherDEPT OF LABOR
1025906OtherUNITED HEALTHCARE