Provider Demographics
NPI:1174847743
Name:AMEDISYS ALASKA, LLC
Entity Type:Organization
Organization Name:AMEDISYS ALASKA, LLC
Other - Org Name:AMEDISYS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:892 E USA CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7188
Practice Address - Country:US
Practice Address - Phone:907-376-7783
Practice Address - Fax:907-376-7784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMEDISYS ALASKA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-25
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHP0002Medicaid
AKHP0002Medicaid