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General NPI Number Information
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NPI Number | 1497712335
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Entity Type | Organization
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Legal Business Name | BAPTIST MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 6019 WALNUT GROVE RD
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City | MEMPHIS
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State | TN
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Zip | 38120-2113
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Country | US
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Telephone | 901-226-0505
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Fax |
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Provider Business Mailing Address
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Address Line | 350 N HUMPHREYS BLVD
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City | MEMPHIS
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State | TN
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Zip | 38120-2177
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR VP/ CLO
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Name | GREGORY DUCKETT
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Credential |
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Telephone | 901-227-5233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 00000104
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License Number State | TN
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