Healthcare Provider Details

I. General information

NPI: 1023520434
Provider Name (Legal Business Name): BAPTIST HEALTHCARE SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 KENTUCKY AVE MEDICAL PARK 1, SUITE 101
PADUCAH KY
42003-3817
US

IV. Provider business mailing address

2601 KENTUCKY AVE MEDICAL PARK 1, SUITE 101
PADUCAH KY
42003-3817
US

V. Phone/Fax

Practice location:
  • Phone: 270-575-5870
  • Fax: 270-575-5873
Mailing address:
  • Phone: 270-575-5870
  • Fax: 270-575-5873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07855
License Number StateKY

VIII. Authorized Official

Name: BENJAMIN KNUCKLES
Title or Position: SYSTEMS MANAGER
Credential: PHARMD, MBA
Phone: 502-928-0030