Provider Demographics
NPI:1881658557
Name:AMEDISYS ARKANSAS, L.L.C.
Entity Type:Organization
Organization Name:AMEDISYS ARKANSAS, L.L.C.
Other - Org Name:AMEDISYS HOSPICE OF MOUNTAIN VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/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 1:5959 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:225-295-9678
Practice Address - Street 1:211 E WASHINGTON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560
Practice Address - Country:US
Practice Address - Phone:870-269-2993
Practice Address - Fax:870-269-5375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR 4559251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR179470747Medicaid
AR136808747Medicaid
AR041527Medicare Oscar/Certification