Healthcare Provider Details

I. General information

NPI: 1811982069
Provider Name (Legal Business Name): AMEDISYS MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SUNBURST HWY
CAMBRIDGE MD
21613-2546
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 410-228-2170
  • Fax: 410-288-2461
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 NumberHH7111
License Number StateMD

VIII. Authorized Official

Name: TRAVIS MIGLICCO
Title or Position: SVP TAX
Credential:
Phone: 225-299-3803