MEDICARE: SAINT JOSEPH HEALTH SYSTEM, 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	282NR1301X	Rural Acute Care Hospital	100281	KY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992701429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT JOSEPH HEALTH SYSTEM, INC

Provider Business Mailing Address
First Line	:	1001 SAINT JOSEPH LN
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40741-8345
Country	:	US
Telephone Number	:	606-330-6000
Fax Number	:	606-330-6020

Provider Business Practice Location Address
First Line	:	1001 SAINT JOSEPH LN
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40741-8345
Country	:	US
Telephone Number	:	606-330-6000
Fax Number	:	606-330-6020

Authorized Official
Title or Position	:	VP FINANCE
Name	:	MR. ROBERT BROCK
Credential	:
Telephone Number	:	606-877-3710

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	11/30/2020

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Directions to “SAINT JOSEPH HEALTH SYSTEM, INC ” Practice Location

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