MEDICARE: AMEDISYS HOSPICE, 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	251G00000X	Community Based Hospice Care Agency	080113431	IN

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	:	1770800369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDISYS HOSPICE, LLC

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-292-2031
Fax Number	:	225-295-9678

Provider Business Practice Location Address
First Line	:	2761 ALBRIGHT RD
Second Line	:	BUILDING B
City	:	KOKOMO
State	:	IN
Zip	:	46902-3996
Country	:	US
Telephone Number	:	765-864-0134
Fax Number	:	765-864-0182

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM BORNE
Credential	:
Telephone Number	:	225-292-2031

Provider Enumeration Date	:	04/22/2010
Last Update Date	:	10/28/2010

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