MEDICARE: AMEDISYS GEORGIA, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	107-242-H	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134177835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDISYS GEORGIA, L.L.C.

Provider Business Mailing Address
First Line	:	3854 AMERICAN WAY
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4013
Country	:	US
Telephone Number	:	225-292-2031
Fax Number	:	225-295-9678

Provider Business Practice Location Address
First Line	:	4162 BAKER ST NE
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-1404
Country	:	US
Telephone Number	:	770-787-1796
Fax Number	:	770-787-6743

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAUL B KUSSEROW
Credential	:
Telephone Number	:	225-292-2031

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	10/24/2017

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