Organization
AMEDISYS MISSISSIPPI, LLC
Active
Other names
Amedisys Home Health of Vicksburg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL B KUSSEROW (PRESIDENT)
(225) 292-2031
Entity
Organization
Contact information
Practice address
2080 S FRONTAGE RD, SUITE 105, VICKSBURG, MS 39180-5328
(601) 619-3670
(601) 619-3672
Mailing address
3854 AMERICAN WAY, SUITE A, BATON ROUGE, LA 70816-4013
(225) 292-2031
(225) 295-9678
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7394
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770548
—
MS
Enumeration date
05/04/2006
Last updated
09/29/2016
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