MEDICARE: SAINT JOSEPH HOSPITAL, 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
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740220458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT JOSEPH HOSPITAL, INC

Provider Business Mailing Address
First Line	:	500 ELDORADO BLVD
Second Line	:	BLDG 6 STE 6250
City	:	BROOMFIELD
State	:	CO
Zip	:	80021
Country	:	US
Telephone Number	:	855-851-4127
Fax Number	:	303-272-0390

Provider Business Practice Location Address
First Line	:	1960 N OGDEN ST STE 460
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-3670
Country	:	US
Telephone Number	:	303-318-2500
Fax Number	:	303-318-2575

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. JAMESON SMITH
Credential	:
Telephone Number	:	303-812-4940

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/11/2021

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