Provider Demographics
NPI:1972749398
Name:THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH
Entity Type:Organization
Organization Name:THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH
Other - Org Name:BAPTIST PALLIATIVE CARE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:KEEFER
Authorized Official - Last Name:BELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-273-4447
Mailing Address - Street 1:PO BOX 241947
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-1947
Mailing Address - Country:US
Mailing Address - Phone:334-273-4520
Mailing Address - Fax:334-273-4425
Practice Address - Street 1:2105 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2409
Practice Address - Country:US
Practice Address - Phone:334-286-3568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-07
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510G700564Medicare PIN