| Baptist Memorial Hospital | |
|
6019 Walnut Grove Rd Memphis TN 38120-2113 | |
| (901) 226-0505 | |
| Not Available |
| Full Name | Baptist Memorial Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 6019 Walnut Grove Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/ CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Memorial Hospital 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: () - | Baptist Memorial Hospital 6019 Walnut Grove Rd Memphis TN 38120-2113 Ph: (901) 226-0505 |
| NPI Number | 1578527172 |
|---|---|
| Provider Enumeration Date | 04/12/2006 |
| Last Update Date | 04/15/2021 |
| Medicare PECOS PAC ID | 6305739475 |
|---|---|
| Medicare Enrollment ID | O20040303000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578527172 | NPI | - | NPPES |
| 0440048 | Medicaid | TN | |
| 12503 | Medicaid | TN | |
| 82178 | Other | AR | BC OF AR PROVIDER NUMBER |
| 300020021 | Other | MS | BC OF MS PROVIDER NUMBER |
| 56540 | Other | TN | BC OF TN PROVIDER NUMBER |
| 107093105 | Medicaid | AR | |
| BA012097606 | Medicaid | MO | |
| 00020374 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | 00000104 (Tennessee) | Primary |
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