AMEDISYS HOSPICE LLC NPI 1396938015

NPI Information

NPI: 1396938015
Provider Name: AMEDISYS HOSPICE LLC

Doing Business As: AMEDISYS HOSPICE CARE OF KENNESAW

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
4255 WADE GREEN RD NW BLDG 300
SUITE 320
KENNESAW, GA
ZIP 30144
Phone: (770) 423-1316
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AMEDISYS HOSPICE LLC is a hospice care community based in Kennesaw, GA. AMEDISYS HOSPICE LLC NPI is 1396938015. The provider is registered as an organization entity type.
The provider Is Doing Business As Amedisys Hospice Care Of Kennesaw.

The provider's business location address is:

4255 WADE GREEN RD NW BLDG 300
SUITE 320
KENNESAW, GA
ZIP 30144-762
Phone: (770) 423-1316
Fax: (770) 426-7453

The provider's authorized official is Paul B Kusserow .
The authorized official title is President and has the following contact phone number (225) 292-2031.

The CLIA number assigned to this NPI record is 11D1078956 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/27/2007 and was last updated on 9/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	538644165A	MEDICAID	GEORGIA
2	111686	MEDICARE OSCAR/CERTIFICATION	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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