Healthcare Provider Details

I. General information

NPI: 1609320563
Provider Name (Legal Business Name): BAPTIST HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR. STE. 330
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

9601 BAPTIST HEALTH DR. STE. 109
LITTLE ROCK AR
72205
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-1388
  • Fax: 501-202-4126
Mailing address:
  • Phone: 501-202-1388
  • Fax: 501-202-4126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TROY WELLS
Title or Position: CHIEF EXECUTIVE OFFICE AND PRESIDEN
Credential:
Phone: 501-202-2055