Amedisys Georgia, LLC
Organization Active NPI Home Health Agency · Douglas, GA
NPI 1457682007 · NPPES record last updated Oct 3, 2016
Key facts
- NPI
- 1457682007
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 148-110 (GA)
- Legal business name
- AMEDISYS GEORGIA, LLC
- Practice address
- 190 Westside Dr
Suite E
Douglas, GA 31533-3533 - Phone
- (912) 383-0840
- Fax
- (912) 383-0838
- NPI assigned
- Jan 21, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- AMEDISYS GEORGIA, LLC
Authorized official
- Name
- Paul B Kusserow
- Title
- President
- Phone
- (225) 292-2031
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Amedisys Georgia LLC
- Part of
- Amedisys Georgia LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 148-110 | GA | Yes |
Addresses
Primary practice location
190 Westside Dr
Suite E
Douglas, GA 31533-3533
Mailing address
3854 American Way
Suite a
Baton Rouge, LA 70816-4013
Phone (225) 292-2031
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000826009J | Medicaid | GA |
Other names
- Amedisys Home Health
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.