Provider Demographics
NPI:1043385610
Name:ST JOSEPHS HOSPITAL OF HUNTINGBURG INC
Entity Type:Organization
Organization Name:ST JOSEPHS HOSPITAL OF HUNTINGBURG INC
Other - Org Name:ST JOSEPHS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WINSETT
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:812-683-6450
Mailing Address - Street 1:1706 MEDICAL ARTS DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542-9049
Mailing Address - Country:US
Mailing Address - Phone:812-683-6410
Mailing Address - Fax:
Practice Address - Street 1:1706 MEDICAL ARTS DR
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-9049
Practice Address - Country:US
Practice Address - Phone:812-683-6410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157200Medicare ID - Type Unspecified