Healthcare Provider Details
I. General information
NPI: 1841245594
Provider Name (Legal Business Name): SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5215 HOLY CROSS PKWY
MISHAWAKA IN
46545-1469
US
IV. Provider business mailing address
5215 HOLY CROSS PARKWAY SAINT JOSEPH HEALTH SYSTEM PROVIDER SERVICES
MISHAWAKA IN
46545-1469
US
V. Phone/Fax
- Phone: 574-335-5000
- Fax:
- Phone: 574-335-8707
- Fax: 574-335-0741
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 06-005012-2 |
| License Number State | IN |
VIII. Authorized Official
Name: MR.
CHRISTOPHER
JAMES
KARAM
Title or Position: PRESIDENT
Credential:
Phone: 574-335-5000