Healthcare Provider Details

I. General information

NPI: 1083610315
Provider Name (Legal Business Name): JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 05/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 DUTCHMANS LN
LOUISVILLE KY
40207-4702
US

IV. Provider business mailing address

PO BOX 2587
LOUISVILLE KY
40201-2587
US

V. Phone/Fax

Practice location:
  • Phone: 502-259-6600
  • Fax: 502-259-6605
Mailing address:
  • Phone: 502-587-4099
  • Fax: 502-587-4944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number100806
License Number StateKY

VIII. Authorized Official

Name: CATHERINE L. SPALDING
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-582-7437