MEDICARE: AMEDISYS WASHINGTON, L.L.C.

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	IHSF60066213	WA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790783504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDISYS WASHINGTON, L.L.C.

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	:	800 JASMINE ST
Second Line	:	SUITE 2
City	:	OMAK
State	:	WA
Zip	:	98841-9501
Country	:	US
Telephone Number	:	509-422-6721
Fax Number	:	509-422-1835

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/20/2013

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