1851397871 NPI number — JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.

Table of content: DR. THOMAS TRUNCALE DO, MPH (NPI 1447292339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851397871 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:
FRAZIER REHAB INSTITUTE JEFFERSONTOWN
Provider Other Organization Name Type Code:
3
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:
1851397871
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2012
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:
10216 TAYLORSVILLE RD
Provider Second Line Business Practice Location Address:
STE 950
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40299-3686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-267-0209
Provider Business Practice Location Address Fax Number:
502-266-0980
Provider Enumeration Date:
06/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FARR
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
502-540-3888

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: 100701 , 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: 0697250 . This is a "AETNA HMO" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000063935 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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