Provider Demographics
NPI:1922004779
Name:BAPTIST HEALTHCARE SYSTEM, INC.
Entity Type:Organization
Organization Name:BAPTIST HEALTHCARE SYSTEM, INC.
Other - Org Name:BAPTIST HEALTH HOME CARE BRECKINRIDGE
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:
Mailing Address - Fax:
Practice Address - Street 1:203 B FAIRGROUNDS ROAD
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-2585
Practice Address - Country:US
Practice Address - Phone:270-756-2662
Practice Address - Fax:270-756-6401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST HEALTHCARE SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-27
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY610525158251E00000X
KYKY150121251E00000X, 376J00000X
KY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY42001149Medicaid
KY000000297139OtherANTHEM BC/BS
KY1050195Medicaid
KY34001149Medicaid
KY34001149Medicaid