Provider Demographics
NPI:1326096074
Name:AMEDISYS NORTH CAROLINA, LLC
Entity Type:Organization
Organization Name:AMEDISYS NORTH CAROLINA, LLC
Other - Org Name:AMEDISYS HOME HEALTH OF CHAPEL HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3803
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 1:100 EUROPA DR STE 330
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2395
Practice Address - Country:US
Practice Address - Phone:919-401-3000
Practice Address - Fax:919-402-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0166251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC34-27030Medicaid
NC1326096074Medicaid
NC347030Medicare Oscar/Certification