Provider Demographics
NPI:1790773158
Name:BAPTIST HEALTH HOSPITALS
Entity Type:Organization
Organization Name:BAPTIST HEALTH HOSPITALS
Other - Org Name:BAPTIST MEDICAL CENTER STUTTGART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-202-2080
Mailing Address - Street 1:9601 BAPTIST HEALTH DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-202-2080
Mailing Address - Fax:501-202-1722
Practice Address - Street 1:1703 N BUERKLE STREET
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-3153
Practice Address - Country:US
Practice Address - Phone:870-673-3511
Practice Address - Fax:870-672-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3903282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ56928OtherBLUE CROSS
AR56928OtherBLUE CROSS
AR100942002Medicaid
AR10072OtherBLUE CROSS
AR56928Medicare ID - Type Unspecified
040072Medicare Oscar/Certification