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Baptist Health Madisonville Inc

Organization Active NPI Clinical Medical Laboratory · Madisonville, KY

NPI 1417138686 · NPPES record last updated Sep 18, 2023

Key facts

NPI
1417138686
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
BAPTIST HEALTH MADISONVILLE INC
Practice address
200 Clinic Dr
Madisonville, KY 42431-1661
Phone
(270) 825-7200
NPI assigned
Nov 16, 2007
Organization subpart
No

Authorized official

Name
Richard Carrico
Title
Cfo
Phone
(502) 896-5006

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2112230Baptist Health Deaconess Medical Group, Inc
200 Clinic Drive, Madisonville, KY 42431		Certificate of waiverApr 25, 2028
18D2112231Baptist Health Deaconess - Endocrinology
200 Clinic Dr, 4TH Floor, Madisonville, KY 42431		Certificate of waiverApr 25, 2028
18D2112232Baptist Health Deaconess Medical Group, Inc
200 Clinic Drive, 5TH Floor, Madisonville, KY 42431		Provider-performed microscopyMay 30, 2027
18D2112233Baptist Health Deaconess Medical Group, Inc
200 Clinic Drive, 1St Floor, Madisonville, KY 42431		Certificate of waiverApr 25, 2028
18D2112235Baptist Health Deaconess Medical Group
200 Clinic Drive, 1St Floor, Madisonville, KY 42431		Certificate of waiverApr 25, 2028
18D2112236Baptist Health Deaconess Pediatrics
200 Clinic Drive, 2ND Floor Pediatrics, Madisonville, KY 42431		Certificate of waiverApr 25, 2028
18D2151203Baptist Health Deaconess Medical Group, Inc
200 Clinic Drive, Madisonville, KY 42431		Certificate of waiverJul 15, 2028

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

200 Clinic Dr
Madisonville, KY 42431-1661

Mailing address

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-7200

Other identifiers

IdentifierTypeStateIssuer
000000061958OtherKYBCBS GROUP NUMBER
37903572MedicaidKY

Other names

  • BAPTIST HEALTH MEDICAL ASSOCIATES LAB Doing business as

Other providers in Madisonville, KY

All providers in Madisonville, KY · Clinical Medical Laboratory in Kentucky

Sources for this page

Verify at the official NPI Registry.