Healthcare Provider Details

I. General information

NPI: 1790743961
Provider Name (Legal Business Name): AMEDISYS HOME HEALTH OF ALABAMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19375 N 3RD ST SUITE 101
CITRONELLE AL
36522-2044
US

IV. Provider business mailing address

3854 AMERICAN WAY SUITE A
BATON ROUGE LA
70816-4013
US

V. Phone/Fax

Practice location:
  • Phone: 251-866-3261
  • Fax: 251-866-3259
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PAUL KUSSEROW
Title or Position: PRESIDENT
Credential:
Phone: 225-292-2031