Provider Demographics
NPI:1356678163
Name:AMEDISYS PENNSYLVANIA, LLC
Entity Type:Organization
Organization Name:AMEDISYS PENNSYLVANIA, LLC
Other - Org Name:AMEDISYS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:BORNE
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:225-296-9678
Practice Address - Street 1:1030 REED AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2039
Practice Address - Country:US
Practice Address - Phone:610-736-3590
Practice Address - Fax:610-736-3595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMEDISYS PENNSYLVANIA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-16
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA397401Medicare Oscar/Certification