MEDICARE: BAPTIST MEMORIAL HOSPITAL UNION COUNTY, 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	282N00000X	General Acute Care Hospital	16239	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000019377	OTHER	MS	MS BC PRO FEE PROVIDER NU
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000020377	OTHER	MS	BLUE CROSS PROVIDER NUMBE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780648352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC.

Provider Business Mailing Address
First Line	:	350 N HUMPHREYS BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2177
Country	:	US
Telephone Number	:	662-532-7631
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 HWY 30 W
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3112
Country	:	US
Telephone Number	:	662-532-7631
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	:	09/30/2020

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Directions to “BAPTIST MEMORIAL HOSPITAL UNION COUNTY, INC. ” Practice Location

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