Healthcare Provider Details

I. General information

NPI: 1396799474
Provider Name (Legal Business Name): AMEDISYS HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 MID ATLANTIC DR
MORGANTOWN WV
26508-4290
US

IV. Provider business mailing address

3854 AMERICAN WAY STE A
BATON ROUGE LA
70816-4897
US

V. Phone/Fax

Practice location:
  • Phone: 304-292-4868
  • Fax: 304-292-4867
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number19
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number19
License Number StateWV

VIII. Authorized Official

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