- Enrollment id
- O20041026000340
- Enrollment state
- VA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1669420337
- Multiple npi flag
- Y
- Ccn
- 497538
- Associate id
- 6901867696
- Organization name
- AMEDISYS HOME HEALTH OF VIRGINIA, LLC
- Doing business as name
- AMEDISYS HOME HEALTH
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 4589 LIFESTYLE LN
- City
- MIDLOTHIAN
- State
- VA
- Zip code
- 231124807