Organization
AMEDISYS WEST VIRGINIA, L.L.C.
Active
Other names
Amedisys Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM F BORNE (PRESIDENT)
(225) 292-2031
Entity
Organization
Contact information
Practice address
RR 2 BOX 54B, BUCKEYE, WV 24924-9641
(304) 799-7488
(304) 799-2348
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 292-2031
(225) 295-9678
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
16
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001105003
—
WV
01
—
001703870
BCBS PROVIDER ID
WV
01
—
1041924
WORKERS' COMP PROVIDER ID
WV
01
—
320838
BLACK LUNG PROVIDER ID
WV
05
—
3810019822
—
WV
Enumeration date
09/14/2005
Last updated
04/19/2012
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