Provider Demographics
NPI:1801028782
Name:AMEDISYS HOSPICE, L.L.C.
Entity Type:Organization
Organization Name:AMEDISYS HOSPICE, L.L.C.
Other - Org Name:AMEDISYS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
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:
Practice Address - Street 1:1124 S BURNSIDE AVE
Practice Address - Street 2:BUILDING 300-B
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4249
Practice Address - Country:US
Practice Address - Phone:225-644-3616
Practice Address - Fax:225-644-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2119419Medicaid
LA2119419Medicaid