Provider Demographics
NPI:1063419034
Name:AMERICAN HOMEPATIENT, INC.
Entity type:Organization
Organization Name:AMERICAN HOMEPATIENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT ASSIST. SEC.
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-8191
Mailing Address - Street 1:PO BOX 532906
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2906
Mailing Address - Country:US
Mailing Address - Phone:501-537-2323
Mailing Address - Fax:501-671-6801
Practice Address - Street 1:216 MARENGO ST
Practice Address - Street 2:SUITE A
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-6012
Practice Address - Country:US
Practice Address - Phone:256-760-1099
Practice Address - Fax:256-760-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL900221332BX2000X
AL274332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
0210310128Medicare ID - Type Unspecified