Provider Demographics
NPI:1780625442
Name:ST. JOSEPH HOSPITAL & HEALTH CENTER, INC.
Entity type:Organization
Organization Name:ST. JOSEPH HOSPITAL & HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, FACHE
Authorized Official - Phone:765-456-5300
Mailing Address - Street 1:1907 W SYCAMORE ST
Mailing Address - Street 2:P.O. BOX 9010
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46904-9010
Mailing Address - Country:US
Mailing Address - Phone:765-456-5300
Mailing Address - Fax:
Practice Address - Street 1:1907 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4197
Practice Address - Country:US
Practice Address - Phone:765-456-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060050102282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100269010AMedicaid
IN100269010AMedicaid
IN940590Medicare PIN