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General NPI Number Information
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NPI Number | 1306832050
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Entity Type | Organization
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Legal Business Name | STJ HEALTHCARE, INC.
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 22 CLINTON STREET
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City | BLOOMVILLE
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State | OH
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Zip | 44818-0069
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Country | US
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Telephone | 419-983-2021
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Fax | 419-983-4500
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Provider Business Mailing Address
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Address Line | PO BOX 69 22 CLINTON STREET
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City | BLOOMVILLE
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State | OH
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Zip | 44818-0069
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Country | US
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Telephone | 419-983-2021
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Fax | 419-983-4500
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CHERYL BARNHART
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Credential |
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Telephone | 419-447-4662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 5850
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License Number State | OH
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