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NPI 1619209301

NPI 1619209301 : AMEDISYS MISSISSIPPI, LLC : PICAYUNE, MS

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General NPI Number Information
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    NPI Number           |    1619209301
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMEDISYS MISSISSIPPI, LLC 
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Dates
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    Enumeration Date     |    02/04/2010
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    Last Update Date     |    09/29/2016
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Provider Practice Location Address
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    Address Line         |    509 HIGHWAY 11 N SUITE B
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    City                 |    PICAYUNE
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    State                |    MS
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    Zip                  |    39466-3349
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    Country              |    US
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    Telephone            |    601-799-2626
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    Fax                  |    601-799-0839
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Provider Business Mailing Address
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    Address Line         |    3854 AMERICAN WAY SUITE A
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    City                 |    BATON ROUGE
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    State                |    LA
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    Zip                  |    70816-4013
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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                 |     PAUL B KUSSEROW 
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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       |    9595
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    License Number State |    MS
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