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	14-012308-1	IN
2	251G00000X	Community Based Hospice Care Agency	15-012308-1	IN
3	251G00000X	Community Based Hospice Care Agency	17-012308-1	IN
4	251G00000X	Community Based Hospice Care Agency	18-012308-1	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	:	1932437779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEDISYS HOSPICE 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	:	225-298-3548
Fax Number	:	225-295-9678

Provider Business Practice Location Address
First Line	:	305 QUARTERMASTER CT
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3670
Country	:	US
Telephone Number	:	812-284-4630
Fax Number	:	812-284-4856

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

Provider Enumeration Date	:	12/04/2009
Last Update Date	:	04/27/2018

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Directions to “AMEDISYS HOSPICE LLC ” Practice Location

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