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General NPI Number Information
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NPI Number | 1497740690
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Entity Type | Organization
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Legal Business Name | AMEDISYS WEST VIRGINIA, L.L.C.
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | RR 2 BOX 54B
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City | BUCKEYE
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State | WV
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Zip | 24924-9641
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Country | US
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Telephone | 304-799-7488
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Fax | 304-799-2348
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 225-292-2031
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Fax | 225-295-9678
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM F BORNE
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Credential |
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Telephone | 225-292-2031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 16
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License Number State | WV
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