Provider Demographics
NPI:1952534083
Name:AMEDISYS GEORGIA LLC
Entity Type:Organization
Organization Name:AMEDISYS GEORGIA LLC
Other - Org Name:AMEDISYS HOME HEALTH
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:225-298-3354
Mailing Address - Fax:
Practice Address - Street 1:1206 CRAWFORD ST
Practice Address - Street 2:SUITE A
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3278
Practice Address - Country:US
Practice Address - Phone:229-928-3483
Practice Address - Fax:229-928-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPENDINGMedicare Oscar/Certification