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General NPI Number Information
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NPI Number | 1316158793
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH'S HOSPITAL
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 5665 PEACHTREE DUNWOODY RD NE
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City | ATLANTA
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State | GA
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Zip | 30342-1701
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Country | US
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Telephone | 404-851-7109
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Fax | 404-851-5657
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Provider Business Mailing Address
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Address Line | 5665 PEACHTREE DUNWOODY RD NE
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City | ATLANTA
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State | GA
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Zip | 30342-1701
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Country | US
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Telephone | 404-851-7109
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Fax | 404-851-5657
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Authorized Official
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Title or Position | VP/CFO
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Name | LISA URBISTONDO
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Credential |
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Telephone | 44-501-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | PHH005132
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License Number State | GA
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