Organization
BAPTIST HEALTH MADISONVILLE INC
Active
Parent organization
BAPTIST HEALTH MADISONVILLE INC
Other names
BAPTIST HEALTH MADISONVILLE RDF
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAPTIST HEALTH MADISONVILLE INC
Authorized official
MR. RICHARD CARRICO (CFO)
(502) 896-5006
Entity
Organization
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 824-3655
Mailing address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1653
(270) 825-5100
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054636
ANTHEM PROVIDER #
KY
05
—
01022219
—
KY
Enumeration date
02/14/2007
Last updated
09/18/2023
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