Provider Demographics
NPI:1386782555
Name:AMERICAN OUTCOMES MANAGEMENT LP
Entity type:Organization
Organization Name:AMERICAN OUTCOMES MANAGEMENT LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-556-4246
Mailing Address - Street 1:6310 SOUTHWEST BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3998
Mailing Address - Country:US
Mailing Address - Phone:800-556-4246
Mailing Address - Fax:855-777-1487
Practice Address - Street 1:34 34TH ST STE B321
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2014
Practice Address - Country:US
Practice Address - Phone:800-556-4246
Practice Address - Fax:855-777-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0248323336H0001X, 3336H0001X
3336S0011X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02292331Medicaid
NJ0000299Medicaid
2058255OtherPK
2058255OtherPK