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NPI Code Detail

MEDICARE: BAPTIST CONVALESCENT CENTER, INC.

MEDICARE: BAPTIST CONVALESCENT CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency150180KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194786632
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAPTIST CONVALESCENT CENTER, INC.
Provider Business Mailing Address
First Line : 800 HIGHLAND AVE
Second Line : SUITE 30
City : FT WRIGHT
State : KY
Zip : 41011-4001
Country : US
Telephone Number : 859-547-3353
Fax Number : 859-547-3344
Provider Business Practice Location Address
First Line : 800 HIGHLAND AVE
Second Line : SUITE 30
City : FT WRIGHT
State : KY
Zip : 41011-4001
Country : US
Telephone Number : 859-547-3353
Fax Number : 859-547-3344
Authorized Official
Title or Position : CEO
Name : DR. ROBERT LONG
Credential : PHD
Telephone Number : 859-491-3800
Provider Enumeration Date : 03/31/2006
Last Update Date : 09/06/2023

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