MEDICARE: BAPTIST HEALTH MEDICAL GROUP, 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1225722689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST HEALTH MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	1901 CAMPUS PL
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-2308
Country	:	US
Telephone Number	:	502-253-4911
Fax Number	:	502-489-5750

Provider Business Practice Location Address
First Line	:	1099 DUVAL ST STE 120
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-6489
Country	:	US
Telephone Number	:	859-639-0090
Fax Number	:	859-639-0091

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DANYEL D CLAY
Credential	:
Telephone Number	:	502-253-4911

Provider Enumeration Date	:	06/07/2023
Last Update Date	:	07/10/2024

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