Provider Demographics
NPI:1174396584
Name:AMEDISYS OREGON, L.L.C.
Entity type:Organization
Organization Name:AMEDISYS OREGON, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP, TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3803
Mailing Address - Street 1:3854 AMERICAN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4897
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 VALLEY RIVER DR STE 170
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2160
Practice Address - Country:US
Practice Address - Phone:541-255-2448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based