Healthcare Provider Details

I. General information

NPI: 1063611218
Provider Name (Legal Business Name): SAINT JOSEPH HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 04/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11203 MAIN STREET
MARTIN KY
41649
US

IV. Provider business mailing address

PO BOX 910
MARTIN KY
41649-0910
US

V. Phone/Fax

Practice location:
  • Phone: 859-313-4120
  • Fax: 859-313-4120
Mailing address:
  • Phone: 859-313-4120
  • Fax: 859-313-3010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number18Z305
License Number StateKY

VIII. Authorized Official

Name: KIMBERLY R MCINTOSH
Title or Position: REVENUE REALIZATION CENTER MANAGER
Credential:
Phone: 85931314120