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Organization

BAPTIST HEALTHCARE AFFILIATES

Active
Other names
Baptist Hospital Northeast Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DENNIS JOHNSON (ADMINISTRATOR)
(502) 222-3329
Entity
Organization

Contact information

Practice address
1025 NEW MOODY LN, LAGRANGE, KY 40031-9154
(502) 222-3362
(502) 222-8684
Mailing address
1025 NEW MOODY LN, LAGRANGE, KY 40031-9154
(502) 222-3362
(502) 222-8684

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
P05196
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1817660
NCPDP
KY
05
54029285
KY
Enumeration date
03/07/2007
Last updated
05/30/2008
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