Healthcare Provider Details

I. General information

NPI: 1487694196
Provider Name (Legal Business Name): SAINT JOSEPH HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ELDORADO BLVD BLDG 6 STE 6250
BROOMFIELD CO
80021
US

IV. Provider business mailing address

500 ELDORADO BLVD BLDG 6 STE 6250
BROOMFIELD CO
80021
US

V. Phone/Fax

Practice location:
  • Phone: 855-851-4127
  • Fax: 303-272-0390
Mailing address:
  • Phone: 855-851-4127
  • Fax: 303-272-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMESON SMITH
Title or Position: PRESIDENT & CEO
Credential:
Phone: 303-812-4940