Provider Demographics
NPI:1104016658
Name:AMEDISYS HOSPICE, L.L.C.
Entity Type:Organization
Organization Name:AMEDISYS HOSPICE, L.L.C.
Other - Org Name:AMEDISYS HOSPICE OF FLORENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:412 S COURT ST
Practice Address - Street 2:SUITE 302
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5645
Practice Address - Country:US
Practice Address - Phone:256-760-7877
Practice Address - Fax:256-760-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALE3911251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL101086Medicaid
AL122453Medicaid
AL011669Medicare Oscar/Certification