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General NPI Number Information
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NPI Number | 1407992951
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Entity Type | Organization
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Legal Business Name | JEWISH HOSPITAL & ST MARYS HEALTHCARE INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 220 ABRAHAM FLEXNER WAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-3826
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Country | US
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Telephone | 502-561-3905
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Fax | 502-561-3906
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Provider Business Mailing Address
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Address Line | 220 ABRAHAM FLEXNER WAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-3826
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Country | US
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Telephone | 502-561-3905
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Fax | 502-561-3906
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARK MILBURN
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Credential |
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Telephone | 502-561-3905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | P07166
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License Number State | KY
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