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DSH180104 BAPTIST HEALTH PADUCAH (Terminated)
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Main Details
Name
BAPTIST HEALTH PADUCAH
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180104
Medicare Provider Number
180104
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/16/2016
Last Recertification Date
8/30/2024
Termination Date
Termination Reason
1/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Baptist Health Paducah
Kenneth Boyd, President
(270) 575-2101
Primary Contact
Baptist Health Paducah
Laura Madison, Director of Pharmacy
(270) 575-2105
Addresses
Street Address
2501 KENTUCKY AVENUE
PADUCAH, KY 42003
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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