Healthcare Provider Details

I. General information

NPI: 1659675403
Provider Name (Legal Business Name): BAPTIST COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12010 SHELBYVILLE RD
LOUISVILLE KY
40243-1054
US

IV. Provider business mailing address

2600 STANLEY GAULT PKWY SUITE 201
LOUISVILLE KY
40223-4197
US

V. Phone/Fax

Practice location:
  • Phone: 502-238-2800
  • Fax: 502-238-2805
Mailing address:
  • Phone: 502-238-2801
  • Fax: 502-238-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number29002
License Number StateKY

VIII. Authorized Official

Name: KATHERINE P SMITH
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 502-238-2801