Healthcare Provider Details

I. General information

NPI: 1841240090
Provider Name (Legal Business Name): OAK TREE HOSPITAL AT BAPTIST NORTHEAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 NEW MOODY LN
LA GRANGE KY
40031-9154
US

IV. Provider business mailing address

1025 NEW MOODY LN
LA GRANGE KY
40031-9154
US

V. Phone/Fax

Practice location:
  • Phone: 502-222-8506
  • Fax: 502-222-8526
Mailing address:
  • Phone: 502-222-8506
  • Fax: 502-222-8526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOE MURRELL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 502-222-8506