Organization
AMEDISYS NORTHWEST, L.L.C.
Active
Parent organization
AMEDISYS NORTHWEST, L.L.C.
Other names
Amedisys Northwest Home Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMEDISYS NORTHWEST, L.L.C.
Authorized official
MR. PAUL B KUSSEROW (PRESIDENT)
(225) 292-2031
Entity
Organization
Contact information
Practice address
111 MOUNTAIN VISTA BLVD, SUITE 145, CANTON, GA 30115-4272
(770) 345-3630
(770) 345-3655
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
112-095
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00208007H
—
GA
01
—
11Q7064002
BRANCH ID
GA
Enumeration date
04/20/2007
Last updated
09/28/2016
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