Healthcare Provider Details

I. General information

NPI: 1447213483
Provider Name (Legal Business Name): BAPTIST HEALTHCARE SYSTEM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRILLIUM WAY
CORBIN KY
40701
US

IV. Provider business mailing address

1 TRILLIUM WAY
CORBIN KY
40701
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-1212
  • Fax: 606-523-8726
Mailing address:
  • Phone: 606-528-1212
  • Fax: 606-523-8726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number34122
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number100417
License Number StateKY

VIII. Authorized Official

Name: RICHARD CARRICO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 502-896-5006