Healthcare Provider Details
I. General information
NPI: 1104450485
Provider Name (Legal Business Name): SAINT JOSEPH HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2020
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1606 PRAIRIE CENTER PKWY STE 210
BRIGHTON CO
80601-4004
US
IV. Provider business mailing address
500 ELDORADO BLVD STE 4300
BROOMFIELD CO
80021-3564
US
V. Phone/Fax
- Phone: 303-318-2610
- Fax: 303-272-0748
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMESON
SMITH
Title or Position: PRESIDENT SAINT JOSEPH HOSPITAL
Credential:
Phone: 303-812-4927