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NPI Code Detail

MEDICARE: JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.

MEDICARE: JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center
2273Y00000XRehabilitation Hospital Unit100616KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000063937OTHERKYANTHEM
20696840OTHERKYAETNA HMO

General Provider Information

NPI Number : 1134125495
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWISH HOSPITAL & ST. MARY'S HEALTHCARE, INC.
Provider Business Mailing Address
First Line : PO BOX 2587
Second Line :
City : LOUISVILLE
State : KY
Zip : 40201-2587
Country : US
Telephone Number : 502-587-4099
Fax Number : 502-587-4944
Provider Business Practice Location Address
First Line : 6801 DIXIE HWY
Second Line : SUITE 129
City : LOUISVILLE
State : KY
Zip : 40258-3913
Country : US
Telephone Number : 502-937-2288
Fax Number : 502-933-8848
Authorized Official
Title or Position : VICE PRESIDENT
Name : CATHERINE L. SPALDING
Credential :
Telephone Number : 502-582-7437
Provider Enumeration Date : 06/22/2005
Last Update Date : 05/17/2017

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