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General NPI Number Information
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NPI Number | 1043744287
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Entity Type | Organization
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Legal Business Name | ST JOSEPH HOSPITAL LLC
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 341 SAINT JOHNS WAY
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City | LEWISTON
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State | ID
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Zip | 83501-2436
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Country | US
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Telephone | 615-844-9800
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Fax | 615-844-9883
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Provider Business Mailing Address
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Address Line | 680 S 4TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2407
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Country | US
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Telephone | 629-253-5121
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, CORPORATE SECRETARY
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Name | KATHY TEAGUE
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Credential |
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Telephone | 629-253-5121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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