NPI Code Details Logo

NPI 1437117090

NPI 1437117090 : AMEDISYS GEORGIA, LLC : DOUGLASVILLE, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1437117090
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    AMEDISYS GEORGIA, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/03/2006
-----------------------------------------------------
    Last Update Date     |    03/28/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3009 CHAPEL HILL RD SUITE C
-----------------------------------------------------
    City                 |    DOUGLASVILLE
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30135-1748
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    770-942-1609
-----------------------------------------------------
    Fax                  |    770-942-2632
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3854 AMERICAN WAY SUITE A
-----------------------------------------------------
    City                 |    BATON ROUGE
-----------------------------------------------------
    State                |    LA
-----------------------------------------------------
    Zip                  |    70816-4013
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    225-292-2031
-----------------------------------------------------
    Fax                  |    225-295-9678
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    SVP TAX
-----------------------------------------------------
    Name                 |     TRAVIS  MIGLICCO 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    225-299-3803
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    048-241-H
-----------------------------------------------------
    License Number State |    GA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.