=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437191152
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAINT JOSEPH COMMUNITY HOSPITAL OF MISHAWAKA, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2006
-----------------------------------------------------
Last Update Date | 08/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 W 4TH ST SUITE 100
-----------------------------------------------------
City | MISHAWAKA
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46544-1948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-252-0300
-----------------------------------------------------
Fax | 574-252-0303
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 W 4TH ST SUITE 100
-----------------------------------------------------
City | MISHAWAKA
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46544-1948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-252-0300
-----------------------------------------------------
Fax | 574-252-0303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF FINANCE
-----------------------------------------------------
Name | MR. ROBERT SINK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 574-335-2348
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------