Healthcare Provider Details

I. General information

NPI: 1235126442
Provider Name (Legal Business Name): ST. JOSEPHS OPERATING COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 US ROUTE 1
FRENCHVILLE ME
04745-6155
US

IV. Provider business mailing address

426 US ROUTE 1 P.O. BOX 469
FRENCHVILLE ME
04745-6155
US

V. Phone/Fax

Practice location:
  • Phone: 207-543-6648
  • Fax: 207-543-6118
Mailing address:
  • Phone: 207-543-6648
  • Fax: 207-543-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number36337
License Number StateME

VIII. Authorized Official

Name: MR. BERNARD DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 207-594-4974