Healthcare Provider Details
I. General information
NPI: 1366600256
Provider Name (Legal Business Name): AMEDISYS HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2008
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 GRAND CENTRAL AVE SUITE 102
VIENNA WV
26105-1300
US
IV. Provider business mailing address
3854 AMERICAN WAY STE A
BATON ROUGE LA
70816-4897
US
V. Phone/Fax
- Phone: 304-424-6270
- Fax: 304-424-6274
- Phone: 225-292-2031
- Fax: 225-298-9678
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 21 |
| License Number State | WV |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 315D00000X |
| Taxonomy | Inpatient Hospice |
| License Number | 21 |
| License Number State | WV |
VIII. Authorized Official
Name:
JOSHUA
PROFFITT
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 617-639-4092