Healthcare Provider Details

I. General information

NPI: 1164433041
Provider Name (Legal Business Name): AMEDISYS MISSOURI, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10675 BUSINESS 21
HILLSBORO MO
63050-5094
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 636-789-4715
  • Fax: 363-797-5876
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number786-7HH
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number786-8HH
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number786-9HH
License Number StateMO

VIII. Authorized Official

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