Healthcare Provider Details
I. General information
NPI: 1154739332
Provider Name (Legal Business Name): BAPTIST HEALTH RICHMOND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 EASTERN BYP
RICHMOND KY
40475-2751
US
IV. Provider business mailing address
PO BOX 34166
LEXINGTON KY
40588-4166
US
V. Phone/Fax
- Phone: 260-407-8007
- Fax: 260-407-8007
- Phone: 859-623-3131
- Fax: 859-625-3535
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAT
OLDS
Title or Position: VP OF SUPPORT SERVICES
Credential:
Phone: 859-625-3795