Provider Demographics
NPI:1386395234
Name:AMEDISYS PENNSYLVANIA, L.L.C
Entity type:Organization
Organization Name:AMEDISYS PENNSYLVANIA, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:651 E PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2752
Mailing Address - Country:US
Mailing Address - Phone:717-998-0010
Mailing Address - Fax:833-764-1706
Practice Address - Street 1:651 E PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2752
Practice Address - Country:US
Practice Address - Phone:717-998-0010
Practice Address - Fax:833-764-1706
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMEDISYS PENNSYLVANIA, L.L.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health