Healthcare Provider Details

I. General information

NPI: 1255412342
Provider Name (Legal Business Name): ST JOSEPH'S REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 CEDAR ST PAVILLION 3 SUITE220
SOUTH BEND IN
46617-2069
US

IV. Provider business mailing address

837 E CEDAR ST. PAVILLION 3 SUITE220
SOUTH BEND IN
46617-2814
US

V. Phone/Fax

Practice location:
  • Phone: 574-237-7750
  • Fax: 574-237-7742
Mailing address:
  • Phone: 574-237-7750
  • Fax: 574-237-7742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number01059937A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number01059937A
License Number StateIN

VIII. Authorized Official

Name: MRS. NANCY - HELLYER
Title or Position: CEO
Credential: RN
Phone: 574-237-7111