Provider Demographics
NPI:1538308887
Name:AMEDISYS ARIZONA, L.L.C.
Entity Type:Organization
Organization Name:AMEDISYS ARIZONA, L.L.C.
Other - Org Name:ARIZONA HOME REHABILITATION AND HEALTH CARE, AN AMEDISYS COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-295-9678
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:225-298-3548
Mailing Address - Fax:
Practice Address - Street 1:1841 W 25TH ST
Practice Address - Street 2:SUITE A-1
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6910
Practice Address - Country:US
Practice Address - Phone:928-344-1701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
037218Medicare Oscar/Certification