1982961900 NPI number — BAPTIST HEALTH RICHMOND, INC.

Table of content: (NPI 1982961900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982961900 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:
PATTIE A CLAY INFIRMARY ASSOC
Provider Other Organization Name Type Code:
4
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:
1982961900
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:
PO 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:
859-623-0984
Provider Business Mailing Address Fax Number:
859-623-0984

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
318 GERI LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40475-2306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-623-0984
Provider Business Practice Location Address Fax Number:
859-623-0984
Provider Enumeration Date:
04/16/2012

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 SERVICE
Authorized Official Telephone Number:
859-625-3795

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  15497 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7100204850 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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