MEDICARE: AMEDISYS OKLAHOMA, 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	7210	OK

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	:	1417905175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDISYS OKLAHOMA, 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	:	1637 S MAIN ST
Second Line	:
City	:	GROVE
State	:	OK
Zip	:	74344-5368
Country	:	US
Telephone Number	:	918-787-9496
Fax Number	:	918-787-9497

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	10/03/2016

Similar Medicare Providers

1104156462 — MS. SHERRY LYNDA ROSA
Practice Location Address:

1629 S MAIN ST
GROVE, OK
74344-5368

Practice Phone: 918-791-9700
Practice Fax:

1578894234 — TONYA LYNN GOLDNER PSRS
Practice Location Address:

1629 S MAIN ST
GROVE, OK
74344-5368

Practice Phone: 918-791-9700
Practice Fax:

1982998878 — HEAVEN AND EARTH HOSPICE LLC
Practice Location Address:

1635 S MAIN ST
GROVE, OK
74344-5368

Practice Phone: 918-323-0100
Practice Fax: 918-323-0131

1619869104 — RENEE SNYDER
Practice Location Address:

1629 S MAIN ST
GROVE, OK
74344-5368

Practice Phone: 918-557-4496
Practice Fax:

1396620274 — JONATHAN DINGLE
Practice Location Address:

1629 S MAIN ST STE A
GROVE, OK
74344-5368

Practice Phone: 918-557-4496
Practice Fax:

1023994621 — NICOLE DINGLE
Practice Location Address:

1629 S MAIN ST STE A
GROVE, OK
74344-5368

Practice Phone: 918-557-4496
Practice Fax:

Directions to “AMEDISYS OKLAHOMA, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.