Healthcare Provider Details

I. General information

NPI: 1588601991
Provider Name (Legal Business Name): JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BLUEGRASS AVE
LOUISVILLE KY
40215-1161
US

IV. Provider business mailing address

PO BOX 2587
LOUISVILLE KY
40201-2587
US

V. Phone/Fax

Practice location:
  • Phone: 502-361-6000
  • Fax:
Mailing address:
  • Phone: 502-587-4099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number100254
License Number StateKY

VIII. Authorized Official

Name: JOHN CLAGG
Title or Position: VP FINANCE
Credential:
Phone: 502-560-8357