Provider Demographics
NPI:1376615740
Name:BAPTIST HEALTHCARE SYSTEM, INC
Entity Type:Organization
Organization Name:BAPTIST HEALTHCARE SYSTEM, INC
Other - Org Name:BAPTIST HEALTH LAGRANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-896-5006
Mailing Address - Street 1:1901 CAMPUS PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2308
Mailing Address - Country:US
Mailing Address - Phone:502-896-5000
Mailing Address - Fax:
Practice Address - Street 1:1025 NEW MOODY LN
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031
Practice Address - Country:US
Practice Address - Phone:502-222-5388
Practice Address - Fax:502-222-3411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST HEALTHCARE SYSTEM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-14
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100763314000000X
KY314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12502589Medicaid
KY12502589Medicaid