MEDICARE: AMEDISYS GEORGIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	060-246-H	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073635660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDISYS GEORGIA LLC

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

Provider Business Practice Location Address
First Line	:	4255 WADE GREEN RD NW
Second Line	:	BUILDING 300, SUITE 310
City	:	KENNESAW
State	:	GA
Zip	:	30144-1762
Country	:	US
Telephone Number	:	770-424-3595
Fax Number	:	770-424-1516

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAUL B KUSSEROW
Credential	:
Telephone Number	:	225-292-2031

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	10/03/2016

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