=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689879389
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMEDISYS HOME HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1300 MCFARLAND BLVD NE
-----------------------------------------------------
City | TUSCALOOSA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35406-2252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-752-0606
-----------------------------------------------------
Fax | 205-752-5137
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2420 ENGLEWOOD DR
-----------------------------------------------------
City | TUSCALOOSA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35405-8893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-752-0606
-----------------------------------------------------
Fax | 205-752-5137
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | STAFF PT
-----------------------------------------------------
Name | KATHERINE GARAYANALA
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 205-752-0606
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | PTH1724
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------