1053656991 NPI number — BAPTIST HEALTH RICHMOND, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053656991 NPI number — BAPTIST HEALTH RICHMOND, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAPTIST HEALTH RICHMOND, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053656991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 34166
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40588-4166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-626-0042
Provider Business Mailing Address Fax Number:
859-626-0047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1013 CENTER DRIVE
Provider Second Line Business Practice Location Address:
#5
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-2407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-626-0042
Provider Business Practice Location Address Fax Number:
859-626-0047
Provider Enumeration Date:
12/04/2012

Additional Information

Authorized Official

Authorized Official Last Name:
OLDS
Authorized Official First Name:
PAT
Authorized Official Middle Name:
Authorized Official Title or Position:
VP SUPPORT SERVICES
Authorized Official Telephone Number:
859-625-3795

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100237890 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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