Provider Demographics
NPI:1902996994
Name:BAPTIST HEALTHCARE SYSTEM, INC.
Entity Type:Organization
Organization Name:BAPTIST HEALTHCARE SYSTEM, INC.
Other - Org Name:BAPTIST HOSPITAL EAST HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-896-5006
Mailing Address - Street 1:6420 DUTCHMANS PKWY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3372
Mailing Address - Country:US
Mailing Address - Phone:502-454-5656
Mailing Address - Fax:502-454-0374
Practice Address - Street 1:6420 DUTCHMANS PKWY
Practice Address - Street 2:SUITE 360
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3372
Practice Address - Country:US
Practice Address - Phone:502-454-5656
Practice Address - Fax:502-454-0374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150085251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY34010561Medicaid
KY000000054484OtherANTHEM PROVIDER NUMBER
KY42017566Medicaid
KY000000054484OtherANTHEM PROVIDER NUMBER