Provider Demographics
NPI:1780876441
Name:AMEDISYS WEST VIRGINIA, L.L.C.
Entity type:Organization
Organization Name:AMEDISYS WEST VIRGINIA, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3516
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 1:2200 GRAND CENTRAL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-1300
Practice Address - Country:US
Practice Address - Phone:304-428-2554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810012506Medicaid
WV517074Medicare Oscar/Certification