Healthcare Provider Details
I. General information
NPI: 1710170204
Provider Name (Legal Business Name): AMEDISYS NEW HAMPSHIRE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2007
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 COMMERCE DR STE 101
BEDFORD NH
03110
US
IV. Provider business mailing address
3854 AMERICAN WAY SUITE A
BATON ROUGE LA
70816-4013
US
V. Phone/Fax
- Phone: 603-421-0414
- Fax: 603-421-0548
- Phone: 225-292-2031
- Fax: 225-295-9678
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 36442 |
| License Number State | NH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 03315 |
| License Number State | NH |
VIII. Authorized Official
Name:
TRAVIS
MIGLICCO
Title or Position: SVP TAX
Credential:
Phone: 225-299-3803