1336298470 NPI number — BAPTIST CONVALESCENT CENTER, INC.

Table of content: (NPI 1336298470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336298470 NPI number — BAPTIST CONVALESCENT CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAPTIST CONVALESCENT CENTER, 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:
1336298470
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 176188
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COVINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41017-6188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-491-3800
Provider Business Mailing Address Fax Number:
859-547-3347

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7341 E ALEXANDRIA PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41001-1037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-694-4450
Provider Business Practice Location Address Fax Number:
859-908-0428
Provider Enumeration Date:
01/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STEWART
Authorized Official First Name:
BRAD
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
859-283-8600

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12500088 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com