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General NPI Number Information
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NPI Number | 1861711368
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Entity Type | Organization
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Legal Business Name | AMEDISYS IDAHO, L.L.C.
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 1480 MIDWAY AVENUE UNIT 7
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City | AMMON
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State | ID
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Zip | 83406-4587
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Country | US
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Telephone | 208-523-1980
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Fax | 208-523-4024
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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 |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD LABORDE
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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 |
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License Number State |
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