Provider Demographics
NPI:1003851981
Name:JEWISH HOSPITAL & ST MARYS HEALTHCARE INC
Entity Type:Organization
Organization Name:JEWISH HOSPITAL & ST MARYS HEALTHCARE INC
Other - Org Name:AMERIMED, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:502-585-7677
Mailing Address - Street 1:PO BOX 950209
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0209
Mailing Address - Country:US
Mailing Address - Phone:502-585-7677
Mailing Address - Fax:502-585-7678
Practice Address - Street 1:5111 COMMERCE CROSSINGS DR STE 130
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-3128
Practice Address - Country:US
Practice Address - Phone:502-585-7677
Practice Address - Fax:502-585-7678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN64000175A3336H0001X
OHNRP.022399200-033336H0001X
KYP065483336S0011X, 332B00000X
KY251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54001326Medicaid
IN200299050AMedicaid
2033005OtherPK
KY90001561Medicaid
0971310002Medicare NSC
K115430OtherHEMOPHILIA MEDICARE