Organization
AT HOME MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARSHA MCNAIR (CFO)
(901) 452-8770
Entity
Organization
Contact information
Practice address
1749 FLORIDA ST, MEMPHIS, TN 38109-1957
(901) 452-8770
(901) 452-9943
Mailing address
1749 FLORIDA ST, MEMPHIS, TN 38109-1957
(901) 452-8770
(901) 452-9943
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0000000824
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003121711
—
TN
05
—
00440681
—
MS
05
—
00883
—
TN
05
—
13201
—
TN
05
—
1454371
—
TN
05
—
145472
—
TN
05
—
152026716
—
AR
01
—
2639857
AETNA
TN
01
—
3121711
BLUE CROSS BLUE SHIELD
TN
Enumeration date
06/24/2005
Last updated
11/09/2011
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