Healthcare Provider Details

I. General information

NPI: 1538565452
Provider Name (Legal Business Name): SAINT JOSEPH CONSTRUCTION COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 CORRINE AVE
CINCINNATI OH
45238-2002
US

IV. Provider business mailing address

PO BOX 58397
CINCINNATI OH
45258-0397
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-0001
  • Fax:
Mailing address:
  • Phone: 513-922-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: RICK G CARLSON
Title or Position: OWNER
Credential:
Phone: 513-922-0001