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1578527172

NPI Code Detail

MEDICARE: BAPTIST MEMORIAL HOSPITAL

MEDICARE: BAPTIST MEMORIAL HOSPITAL

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	261QM1300X	Multi-Specialty Clinic/Center
2	282N00000X	General Acute Care Hospital	00000104	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	82178	OTHER	AR	BC OF AR PROVIDER NUMBER
4	300020021	OTHER	MS	BC OF MS PROVIDER NUMBER
5	56540	OTHER	TN	BC OF TN PROVIDER NUMBER
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578527172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	350 N HUMPHREYS BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6019 WALNUT GROVE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2113
Country	:	US
Telephone Number	:	901-226-0505
Fax Number	:

Authorized Official
Title or Position	:	SR VP/ CLO
Name	:	GREGORY M DUCKETT
Credential	:
Telephone Number	:	901-227-5233

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	04/15/2021

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Directions to “BAPTIST MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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