Provider Demographics
NPI:1972848166
Name:BSA HOSPITAL LLC
Entity Type:Organization
Organization Name:BSA HOSPITAL LLC
Other - Org Name:BAPTIST ST ANTHONY'S HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PETROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-296-3000
Mailing Address - Street 1:1 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6293
Mailing Address - Country:US
Mailing Address - Phone:615-296-3000
Mailing Address - Fax:615-296-6011
Practice Address - Street 1:600 N TYLER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5247
Practice Address - Country:US
Practice Address - Phone:806-212-8028
Practice Address - Fax:806-212-8290
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BSA HEALTH SYSTEM OF AMARILLO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001676251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451509Medicare UPIN