Healthcare Provider Details

I. General information

NPI: 1609005131
Provider Name (Legal Business Name): SAINT JOSEPH HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11176 MAIN STREET
MARTIN KY
41649-0910
US

IV. Provider business mailing address

PO BOX 910
MARTIN KY
41649-0910
US

V. Phone/Fax

Practice location:
  • Phone: 606-285-3690
  • Fax:
Mailing address:
  • Phone: 606-285-3690
  • Fax: 606-285-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHY STUMBO
Title or Position: PRESIDENT
Credential:
Phone: 606-285-6602