Healthcare Provider Details

I. General information

NPI: 1689899007
Provider Name (Legal Business Name): AMEDISYS GEORGIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HIGHWAY 98 EAST SUITE A
DANIELSVILLE GA
30633-6928
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6080
US

V. Phone/Fax

Practice location:
  • Phone: 706-795-2294
  • Fax: 706-796-0217
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 Number059-240
License Number StateGA

VIII. Authorized Official

Name: MR. WILLIAM BORNE
Title or Position: CEO
Credential:
Phone: 225-292-2031