Healthcare Provider Details

I. General information

NPI: 1255382412
Provider Name (Legal Business Name): ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD
PHOENIX AZ
85013-4409
US

IV. Provider business mailing address

FILE 56765
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3000
  • Fax: 602-406-6132
Mailing address:
  • Phone: 602-406-3860
  • Fax: 602-406-6132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE BLUMENTHAL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-406-3124