1992701429 NPI number — SAINT JOSEPH HEALTH SYSTEM, INC

Table of content: (NPI 1992701429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992701429 NPI number — SAINT JOSEPH HEALTH SYSTEM, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT JOSEPH HEALTH SYSTEM, 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:
CHI SAINT JOSEPH LONDON
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:
1992701429
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 SAINT JOSEPH LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONDON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40741-8345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-330-6000
Provider Business Mailing Address Fax Number:
606-330-6020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 SAINT JOSEPH LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONDON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40741-8345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-330-6000
Provider Business Practice Location Address Fax Number:
606-330-6020
Provider Enumeration Date:
06/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BROCK
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
606-877-3710

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X , with the licence number:  100281 , 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: 1022185 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 023664600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com