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General NPI Number Information
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NPI Number | 1982553855
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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 | 01/24/2026
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Last Update Date | 01/24/2026
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Provider Practice Location Address
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Address Line | 320 WARNER DR
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City | LEWISTON
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State | ID
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Zip | 83501-4441
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Country | US
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Telephone | 208-743-3523
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Fax | 833-941-3874
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Provider Business Mailing Address
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Address Line | PO BOX 94250
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City | SEATTLE
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State | WA
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Zip | 98124-6550
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Country | US
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Telephone | 208-750-7462
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Fax | 208-750-7467
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHNETTA TRAYLOR
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Credential |
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Telephone | 502-596-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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