Provider Demographics
NPI:1780889402
Name:AMEDISYS PENNSYLVANIA, L.L.C.
Entity type:Organization
Organization Name:AMEDISYS PENNSYLVANIA, 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:GERALD
Authorized Official - Last Name:GINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3726
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 1:480 NEW HOLLAND AVE
Practice Address - Street 2:BUILDING 8, SUITE 8101
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2291
Practice Address - Country:US
Practice Address - Phone:717-291-8396
Practice Address - Fax:717-291-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA740105251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020418560001Medicaid
PA397401CMedicare Oscar/Certification