1275532152 NPI number — JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.

Table of content: (NPI 1275532152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275532152 NPI number — JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275532152
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2587
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40201-2587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-587-4099
Provider Business Mailing Address Fax Number:
502-587-4944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4801 OLYMPIA PARK PLZ
Provider Second Line Business Practice Location Address:
SUITE 1600
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40241-2090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-426-3353
Provider Business Practice Location Address Fax Number:
502-426-4122
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SPALDING
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
502-582-7437

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273Y00000X , with the licence number: 100997 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000363851 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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